Proctitis

WHAT YOU SHOULD KNOW:

• Proctitis is inflammation (redness and swelling) of the lining of your rectum. The rectum is the last part of your large intestine (bowel) that ends at your anus. Your anus is the opening where your stool (bowel movement or BM) passes out. Inflammation of the rectum that reaches the colon is called proctocolitis. Proctitis may be an acute (short-term) or chronic (long-term) condition. It may be caused by infections (sexually or non-sexually transmitted), or radiation to the pelvic (hip) area. It may also be caused by food allergies or bowel conditions such as Crohn's disease or ulcerative colitis.
  
  
• Bleeding, discharge, and pain in your anus or rectum are common signs and symptoms of proctitis. You may have changes in BM habits, such as diarrhea (loose BM's) or constipation (dry, hard stools). You may have problems controlling your BM's, and feel that you cannot fully empty your rectum. Your caregiver may carefully check your anal area and rectum. Tests such as an anoscopy, endoscopy, lab tests, and allergy testing may also be done. Treatment will depend on what the cause of your proctitis is. Treatment may include medicines, diet changes, procedures to stop bleeding, or surgery. With treatment, your symptoms may be relieved and your condition may go away without having more serious problems.

CARE AGREEMENT:

You have the right to help plan your care. To help with this plan, you must learn about your health condition and how it may be treated. You can then discuss treatment options with your caregivers. Work with them to decide what care may be used to treat you. You always have the right to refuse treatment.

RISKS:

• Medicines used to treat proctitis may cause an allergic response. You may have itching, redness, and swelling of your skin, and you may have trouble breathing. You may have headaches, nausea (upset stomach), diarrhea, and abdominal (stomach) pain. Medicines put into your rectum may cause discomfort and cramps. Some tests or procedures done inside your bowels may cause a bowel perforation (tear) and narrowing.
  
  
• If proctitis is left untreated, you may have more serious problems. You may have increased bleeding. Tissues in your rectum may breakdown, leading to ulcers or scars. Germs causing your infection may enter your tissues and cause an abscess (collection of pus). When scar tissue forms, narrowing of your rectum may occur. A fistula (abnormal connection) may form, which connects your anus or rectum to your skin or another organ. If you are female, a fistula may connect your rectum to your vagina. Ask your caregiver if you are worried or have questions about your condition, care, or treatment.

WHILE YOU ARE HERE:

Informed consent: You have the right to understand your health condition in words that you know. You should be told what tests, treatments, or procedures may be done to treat your condition. Your doctor should also tell you about the risks and benefits of each treatment. You may be asked to sign a consent form that gives caregivers permission to do certain tests, treatments, or procedures. If you are unable to give your consent, someone who has permission can sign this form for you. A consent form is a legal piece of paper that tells exactly what will be done to you. Before giving your consent, make sure all your questions have been answered so that you understand what may happen.

IV: An IV is a tube placed in your vein for giving medicine or liquids. This tube is capped or connected to tubing and liquid.

Blood transfusion: You may need blood put back into your body if you have lost large amounts. During a blood transfusion, you will get whole blood, or parts of blood through an IV.

Intravenous fluids: You may need special fluids given through an IV if you become dehydrated (body fluid loss).

Vital signs: This includes taking your temperature, blood pressure, pulse (counting your heartbeat), and respirations (counting your breaths). To take your blood pressure, a cuff is put on your arm and tightened. The cuff is attached to a machine which gives your blood pressure reading. Caregivers may listen to your heart and lungs by using a stethoscope. Your vital signs are taken so caregivers can see how you are doing.

Medicines: Your caregiver may give you the following kinds of medicines:

• Antibiotics: Antibiotics may be given to help treat or prevent an infection caused by germs called bacteria.
  
  
• Anti-inflammatory medicine: This medicine will help prevent your body from releasing special chemicals that can cause swelling. Common anti-inflammatory medicines used to treat proctitis include aminosalicylates (5-ASA). This medicine may also be applied to a skin area with an ulcer.
  
  
• Antiulcer medicine: Antiulcer medicines will coat your bowel to help prevent further damage to your tissues. It may also help with tissue healing.
  
  
• Antiviral medicine: Antiviral medicine may be given to fight an infection caused by a germ called a virus.
  
  
• Steroids: Steroid medicine may be given to decrease swelling. This medicine may help ease your symptoms but may also have side effects. Be sure you understand why you need steroids. Do not stop taking this medicine without your caregivers OK. Stopping on your own can cause a bad response.
  
  
• Short chain fatty acids: Short chain fatty acids (SCFA) will help repair your bowel tissues faster. SCFA treatment is usually done with radiation proctitis.

Tests:

• Anoscopy: This test lets caregivers look inside your anus and rectum. During this test, a clear jelly-like lotion is put onto a short plastic or metal tube. The tube is then gently put into your anus and up the rectum. Your caregiver may also take samples of BM to be sent to a lab for tests. This may help caregivers find the cause of your problem.
  
  
• Endoscopy: This test is done to look for changes or abnormal tissue inside your bowel. This test may also help find the cause of your bleeding or pain. A long, thin tube with a tiny camera on the end is put into your anus. Caregivers will look for problems in your rectum and colon. A small amount of tissue may be taken from your bowel wall and sent for tests. Bleeding may also be treated during this test.
  
  
• Lab tests: These include tests to check what germ is causing your proctitis. A sample of your blood, stool, or fluid discharge may be taken. A sample may also be taken by rubbing a cotton swab over your ulcer. The sample will be sent to a lab for tests.

Treatment options:

• Procedures to stop bleeding:
  
  
  • Formalin: Formalin is a chemical solution that may be used to control bleeding. Treatment is done by applying the solution on the walls of your rectum using a swab stick. Your bowels may then be rinsed with a saline solution. This treatment may be used for radiation proctitis.
    
    
  • Heat therapy: This treatment uses heat to control bleeding and diarrhea caused by radiation. Heat therapy includes laser therapy or argon plasma coagulation (APC). Ask your caregiver for more information on heat therapy.
    
    
  • Hyperbaric oxygen therapy: This is also called HBOT. It is used to increase the oxygen in your body. HBOT may help promote healing of tissues damaged by radiation.
  
  
• Surgery: Surgery may be needed if other treatments have failed. Surgery to remove the damaged part of your bowel may be done.

Copyright © 2008 Thomson Healthcare Inc. All rights reserved. Information is for End User's use only and may not be sold, redistributed or otherwise used for commercial purposes.

The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

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