Purulent proctitis symptoms. What is proctitis? Types, symptoms and methods of treatment of the disease. Possible complications of the disease

Proctitis - is an inflammation of the lining of the rectum. Proctitis should not be confused with paraproctitis, in which there is inflammation of the tissues adjacent to the rectum.

Proctitis disease begins with simple redness and can reach deep ulcers. The disease is quite delicate, so not every person immediately consults a doctor when the first symptoms appear. But in vain! Constant pain and itching in the anus, insomnia, difficulty with defecation, can lead to nervous breakdowns and problems at work and in personal life. In addition, proctitis can develop against the background of such serious diseases as hemorrhoids, microcracks in the anus and rectal cancer!

The structure of the rectum

The rectum is the final section of the intestine, it begins in the sigmoid colon and ends with the anus. The lining of the rectum is made up of muscle and has a lot of mucus to help push food through.

Two muscle rings (anal sphincters), contracting, retain feces. And during their relaxation, defecation occurs. In men, the rectum is attached to the prostate and bladder, in women, to the vagina and uterus.

With the correct functioning of the rectum, all processes go unnoticed, but with any failure, inflammation of the rectum may develop. More than 30% of people with inflammatory bowel disease have rectal inflammation. One of the most common diseases is proctitis.

Proctitis, its types

Proctitis can be acute or chronic.

Acute proctitis has persistent symptoms that appear in a person for a short time. Inflammation of the rectum in an acute form is accompanied by an increase in temperature, general weakness, malaise. It may be caused by acute infectious diseases and rectal injury.

Varieties of acute proctitis:

catarrhal proctitis

Catarrhal proctitis is the first stage of inflammation of the rectum in its acute form. It is characterized by pain in the abdomen and anus, the appearance of blood droplets on toilet paper after defecation.

Catarrhal proctitis can be divided into:

• catarrhal hemorrhagic proctitis (the mucous membrane of the rectum is red, edematous, has a large number of hemorrhages);
• catarrhal-purulent proctitis (pus appears on the mucous membrane of the rectum);
• catarrhal mucosal proctitis (swelling, inflammation of the rectum is accompanied by the appearance of a large amount of mucus).

Polyposis proctitis

With polypous proctitis, small seals resembling polyps grow on the mucous membrane of the rectum.

Erosive proctitis

Erosive proctitis is characterized by the formation of erosion on the mucous membrane. Ulcerative proctitis is a type of erosive proctitis, when ulcers begin to open on the rectal mucosa. There are ulcerative necrotic and purulent fibrous proctitis.

Radiation proctitis

Radiation proctitis appears at the end of radiation therapy. It is characterized by attacks of acute pain, the stool is accompanied by pus and blood, ulcers form on the rectum, a fistula or even lymphostasis may open, which, growing, is able to close the space in the rectum.

Chronic proctitis

The symptoms of chronic proctitis are not so intense, but can be disturbing for a long time. Cycles of exacerbation and remission are periodically repeated. This type of inflammation of the rectum is caused by chronic infections, autoimmune diseases, malignant tumors of the rectum, vascular pathology.

Chronic proctitis is divided into:

• atrophic proctitis (thinning of the mucous membrane of the rectum);
• hypertrophic proctitis (thickening and loosening of the mucous membrane).

Symptoms of proctitis

All symptoms of inflammation of the rectum can be divided into local signs of inflammation of the rectum and general (the reaction of the whole organism to inflammation).

To prescribe the correct treatment for inflammation of the rectum, you need to conduct a complete examination of the human body. The diagnosis is established on the basis of all data, including a digital examination of the rectum, examination of the intestine with the help of rectoscopy, colonoscopy, biopsy of the intestinal wall, stool culture.

The method of treating proctitis is determined by the nature of the disease, its severity, the presence of symptoms, the development of complications, etc. Some patients need short-term treatment for inflammation of the rectum, others need long-term treatment and medical supervision.

Drug treatment of proctitis

Any treatment for inflammation of the rectum should be selected purely individually by a doctor, self-medication is unacceptable!

If an allergic component is present during inflammation of the rectum, then an antihistamine may be prescribed. With constipation, laxatives and a sparing diet are prescribed.

The treatment regimen for inflammation of the rectum is selected individually for each patient.

Local treatment of proctitis

In the treatment of proctitis, the role of local therapy is very important.

Typically, the treatment regimen includes:

• the use of enemas with a solution of colibacterin, potassium permanganate, warm infusion of chamomile, oak bark;
• treatment of proctitis with suppositories (anuzol, proctosedil, etc.) will help reduce itching and remove inflammation in the rectum;
• warm baths with infusion of knotweed (highlander), immortelle;
• the use of ointments (bezornil, proctosan) will relieve pain and contribute to the rapid healing process of damaged tissues;
• for inflammation of the rectum, sea buckthorn oil, sea buckthorn suppositories are used as a local remedy. This quickly relieves inflammation and leads to tissue regeneration.

Diet for proctitis

In order to avoid complications with proctitis, you need to remove fatty, spicy, salty and sour foods from your diet, which cause irritation of the rectum. With inflammation of the rectum, it is recommended to use soups from mashed vegetables, cereals on the water, low-fat cottage cheese and meat, jelly, sour-milk products. It is necessary to exclude sweets and alcohol.

In the multidisciplinary clinic "MedicCity" is given great importance treatment of proctological diseases. Our center employs highly qualified and delicate coloproctologists, owning advanced methods of diagnostics and treatment. Here you can cure hemorrhoids, anal fissure, anal sphincter insufficiency, coccyx cysts, paraproctitis and many other diseases.

Depending on the severity of the disease, you may be offered a conservative or surgical treatment. Modern minimally invasive operations allow you to cure diseases such as hemorrhoids in 1 day, without hospitalization, on an outpatient basis!

It is customary to call proctitis an inflammatory lesion of the rectum of various origins, the severity of which varies from slight reddening of the mucosa to deep ulcers. Depending on the reasons that caused it, coloproctologists, infectious disease specialists, surgeons, allergists or gastroenterologists can deal with the treatment of this ailment, but the symptoms of proctitis are similar.

Proctitis is localized in a rather delicate area human body, so many try to postpone a visit to a specialized doctor or are terribly afraid of examining this area. However, in order to get rid of an unpleasant disease as soon as possible, it is necessary to thoroughly know its cause. Treatment at random or on the advice of non-professionals is fraught with a chronic process, its aggravation and the appearance of complications that require surgical manipulations.

Causes

As a rule, the causes of proctitis are infection and disorders from the side immune system.

And there are many reasons for the development of proctitis. Inflammatory changes in the rectum can lead to:

Proctitis of different origin may have an identical clinical picture, but require completely different therapeutic measures.

Symptoms

Symptoms of proctitis may be due to the lesion of the rectum itself (local) or be associated with a systemic reaction of the whole body to inflammation (systemic).

Systemic manifestations of proctitis, indicating the severity of the process, may be:

• fever;
• weight loss
• loss of appetite;
• weakness;
• psychoemotional disorders;
• rash;
• joint pain;
• lacrimation, redness of the eyes.

The last three symptoms are observed in allergic, immune or infectious lesions. Sometimes they even precede local manifestations.

Diagnostics

For any origin of proctitis, patients need a full examination. Only a specialist can correctly determine its volume. Most often, the list of diagnostic procedures includes:

Instrumental examinations are not very pleasant for the patient, but are quite tolerable. If the doctor insists on the need for fibrocolonoscopy, then this sometimes painful procedure should not be immediately rejected. In most hospitals and modern outpatient clinics, it can be performed by placing the patient in a state of drug-induced sleep.

Treatment

Rectal suppositories are widely used in the treatment of proctitis, since they have their effects directly in the lesion.

Only after finding out the exact causes of proctitis, the doctor can start treatment. Its composition and character vary greatly, since it is determined by the nature of proctitis, its severity, the presence of systemic symptoms, the development of complications (narrowings, fistulas, intestinal obstruction, precancerous transformation of the mucosa, etc.). Some patients are prescribed a short course (more often with acute proctitis), while others need lifelong treatment and medical supervision.

The complex treatment of proctitis may include:

• pharmacological (local and systemic) agents;
• physiotherapy;
• herbal medicine;
• surgical operations.

In the treatment of proctitis (as opposed to inflammation of other parts of the intestine), the role of local therapy is extremely important. The anatomical localization and small length of the rectum make it possible to widely use all kinds of therapeutic enemas (with medicines, herbs, oils, fish oil, mineral water etc.), suppositories, foams, which are injected directly into the anus. In some situations, you can even limit yourself to exclusively local therapy.

Drug treatment

A wide arsenal of pharmacotherapy for proctitis may include:

Of course, all of the listed drug groups are not assigned to one patient. They are selected purely individually, sometimes a change of drugs is required.

Physiotherapy

With proctitis, physiotherapy procedures should be prescribed very deliberately and carefully. Otherwise, they will cause even greater activation of the pathological process or bleeding.

In order to reduce inflammation, physiotherapists may recommend electrophoresis sessions with calcium chloride or novocaine, sinusoidal modulated currents, UHF, irrigation of the intestine with mineral water (subaquatic baths), mud therapy, electropuncture, etc. Some of these procedures are allowed in the acute period, but most are used outside the exacerbation phase .

Phytotherapy

For microclysters or therapeutic sitz baths, infusions or decoctions from plants that have an antiseptic, anti-inflammatory or astringent effect are used. They are prepared from St. John's wort, sage, flax seed, chamomile, celandine, cinquefoil, calendula, elder flowers, burnet root, oak bark, knotweed, succession.

Proctitis of the rectum belongs to the group of diseases that, despite the absence of a direct threat to life, significantly reduce its quality.

The constantly present feeling of discomfort in the rectum, caused by the inflammatory process and accompanied by intestinal disorders, poisons the patient's habitual existence. Proctitis is an inflammation that spreads in the mucous membrane of the rectum, in which there are unpleasant sensations during defecation in the form of burning, itching, hyperthermia, and in the case of an acute form - intoxication of the body.

In addition to the acute nature, proctitis is able to take a subacute and chronic form, each of them has its own causes of development.

Classification

A disease in which the mucous membrane of the rectum becomes inflamed is called proctitis. The reasons that can lead to the fact that an inflammatory process develops in the colon can be very different. Depending on them, the following forms of the disease are distinguished:

In addition, the development of inflammatory processes in the rectum can cause a number of other factors: hypothermia, other intestinal diseases, hemorrhoids, rectal injuries, chronic inflammation of neighboring organs, anal fissure, prostatitis, vulvovaginitis, etc.

There are also acute and chronic proctitis.

Causes

The main reasons for the development of proctitis include the following:

In adults, the symptoms of proctitis (see photo) may be due to the lesion of the rectum itself (local) or be associated with a systemic reaction of the whole body to inflammation (systemic).

Systemic manifestations of proctitis, indicating the severity of the process, may be:

• fever;
• weight loss
• loss of appetite;
• weakness;
• psychoemotional disorders;
• rash;
• joint pain;
• lacrimation, redness of the eyes.

The last three symptoms are observed in allergic, immune or infectious lesions. Sometimes they even precede local manifestations.

Symptoms of chronic proctitis

In the presence of this form of the disease, periods of exacerbation always alternate with periods of remission. The main criterion for diagnosis is the duration of the disease for more than 6 months.

The clinical picture of the pathology outside the period of exacerbation in most cases is limited to a periodic feeling of discomfort in the rectum. Since the cause of the development of chronic proctitis is most often the presence of another pathology, the symptoms primarily reflect the disease that caused the problem.

The clinical picture and treatment of proctitis during an exacerbation of the disease are no different from the acute form of pathology.

Symptoms of radiation proctitis

Radiation proctitis is a type of chronic form of the disease, however, some clinicians classify it as a separate type. The main difference is a pronounced pain syndrome ("excruciating"), which accompanies the patient all the time. Unfortunately, to date, it has not been developed effective remedy for pain relief of radiation proctitis, so it is very difficult to eliminate such a symptom.

In addition to local manifestations, radiation proctitis is characterized by the presence of common symptoms:

• suppression of immunity, which increases the risk of developing respiratory and intestinal diseases;
• lack or significant decrease in appetite;
• weight loss.

The clinical picture of the pathology is not limited to this, since radiation sickness has a significant effect on other organs.

Proctitis in children

Proctitis in children can manifest itself, especially in the period up to a year old. The reasons are intolerance to milk, protein, the presence of worms, constipation, intestinal infections, swallowing solid objects, malnutrition, enema, violence. Proctitis manifests itself in secretions, mucous, bloody or purulent, on diapers, discoloration of the skin, weight loss, constipation and bloating, dermatitis.

If such symptoms appear, you should take the baby to a pediatrician who will examine him and prescribe treatment: artificial nutrition, dieting, taking antispasmodics, setting enemas and suppositories, UHF, ultrasound, etc.

Diagnostics

The final diagnosis is determined by the results of all examinations and examinations of the patient. As an additional diagnostic method, a study of the vagina in women or the urethra in men is carried out to exclude a gonorrheal or trichomonas cause of the disease. If necessary, conduct a study for the presence of intestinal tuberculosis.

As an examination for the detection of proctitis, instrumental diagnostic methods are used. Most often, specialists resort to sigmoidoscopy, with which you can examine the mucous membrane lining the rectum from the inside and, in some situations, the final section of the sigma. Since this technique is considered one of the most accurate diagnostic methods that allows an objective assessment of more than 35 centimeters of the intestine, the examination primarily focuses on the following changes:

• condition of the intestinal walls;
• presence of structural changes;
• deviations from the color norm;
• existing pathological formations;
• discharge of purulent secretions or mucus;
• condition of the vascular pattern.

The examination procedure is carried out by a special optical instrument- sigmoidoscope, and in case of complex cases of proctitis with its erosive, polypous, catarrhal-purulent or ulcerative character, an additional biopsy is performed followed by histology. During the examination, according to the testimony of a doctor, an agent containing antibiotics is applied, which accelerates the healing of damaged areas of the mucosa. In the form of additional diagnostic methods that allow to establish the causes of the inflammation that has arisen in the rectum, they resort to colonoscopy or FGDS.

Possible complications of the disease

1. Acute paraproctitis is an acute inflammation of the tissues surrounding the rectum;
2. Significant decrease in immunity;
3. Sigmoiditis - inflammation of the sigmoid colon;
4. Malignant neoplasms in the rectum.

As you can see, all possible complications are dangerous, so they really should be feared. So, for example, with the development of acute paraproctitis without surgical intervention, it will be impossible to cope with the pathology. To prevent the development of all these conditions, you should consult a proctologist when the very first signs of proctitis occur.

Treatment of proctitis

The treatment approach is significantly different various types proctitis, so the first step to successfully getting rid of the disease is high-quality diagnostics. Only a qualified doctor can conduct it and prescribe appropriate therapy ( best option is a proctologist.

Medical treatment

Usually, proctitis therapy is carried out on an outpatient basis. But in severe forms of inflammation, the patient is recommended to be treated in a hospital: firstly, this allows the patient to follow a diet, secondly, it helps to give up bad habits and lead a healthy lifestyle, and thirdly, it provides effective treatment under the supervision of experts.

With proctitis, the patient may be prescribed the following drugs:

1. Antibacterial and antiviral, depending on the results of bacteriological studies (metronidazole, chloramphenicol, penicillins, macrolides, etc.)
2. Antispasmodics (No-shpa) - to relieve pain, eliminate spasm, facilitate defecation.
3. Antiallergic drugs - relax the walls of the rectum.
4. Means that improve tissue regeneration (suppositories with methyluracil, sea buckthorn oil) - help restore the mucous membrane, improve metabolic processes, and relieve symptoms of inflammation.
5. Hormonal drugs (dexamethasone, hydrocortisone) - are prescribed for certain types of proctitis.

As additional measures recommended cleansing enemas (to ensure bowel movements), enemas with medicinal solutions, herbs (chamomile, calendula, collargol). Sedentary baths with potassium permanganate have a local antiseptic effect.

Diet

With proctitis, you need to exclude from the diet all foods that irritate the rectum: spicy, salty, sour, fatty, spices. During acute proctitis and chronic exacerbation, vegetables, fruits, berries, and any sweets should be temporarily abandoned.

Approximate diet for proctitis:

Treatment of chronic proctitis

With this form, all the efforts of the doctor are aimed at detecting and eliminating the manifestations of the underlying disease (due to which inflammation of the rectum has developed). Its successful therapy is the only way to get rid of chronic proctitis. Treatment regimens possible causes very complex, so we will describe only the fundamental points:

Pain comes to the fore with radiation proctitis. It is so pronounced that patients do not find a place for themselves from pain. Therefore, it can be removed with any pharmacological drug that is effective for the patient. Perhaps the appointment of narcotic analgesics, NSAIDs, antispasmodics, and so on.

In addition, be sure to carry out therapy aimed at reducing the damaging effects of radiation. For this purpose, antioxidants are used (ascorbic acid; tocopherol, and so on). To reduce inflammation, local hormonal agents are used (Ultraprokt, Doloprokt).

This is only an approximate treatment regimen for radiation proctitis, adequate treatment can only be prescribed individually, directly when contacting a radiologist.

Currently, proctitis is not a dangerous disease. Developed effective ways treatment various forms disease, which allows you to achieve either a complete recovery or a stable remission. The main thing that the patient should do for this is to consult a doctor in a timely manner, since prolonged self-medication can lead to the development of complications and aggravation of the severity of the disease.

What to do at home?

Any uncomplicated proctitis with a mild course can be treated at home. But still, at home, you should adhere to the recommendations of the proctologist, and not self-medicate, since it is imperative to diagnose the disease and differentiate it from many other pathologies of the rectum. After all, all the symptoms are similar to such a terrible and widespread disease in modern times as rectal cancer, in which self-medication is a deterioration and loss of precious time.

Principles of treatment of proctitis at home:

1. Diet with the exception of spicy, salty, fatty, fried foods, as well as raw foods of plant origin.
2. Light exercise, avoid prolonged sitting.
3. Hygiene of intimate places.
4. Refusal of anal sex during illness.
5. Rejection bad habits especially any alcohol.
6. Drug treatment of proctitis: tablets (less often injections), introduction medicines in the form of enemas, suppositories.
7. Warm sitz baths.
8. Alternative methods of treatment should be in combination with traditional ones, and not replace them. It must be remembered that improper treatment of acute proctitis leads to chronic proctitis, that is, the patient dooms himself to the disease for life.
9. In the presence of complications of proctitis, it is urgent to consult a doctor, an operation may be necessary.

Most effective methods traditional medicine for the treatment of proctitis:

A decoction of calendula flowers. 2 tablespoons of calendula flowers pour 200.0 ml of boiling water and put in a water bath for 20 minutes, stirring occasionally. Cool and bring to a volume of 200.0 ml.	For an enema: 100.0 ml of decoction is diluted with 50.0 ml of boiled water and administered as an enema (the diluted decoction should be at room temperature). For boric acid enema: 1 tablespoon calendula infusion + 1 tablespoon 3% boric acid. For oral administration: 2 tablespoons 30 minutes before meals 3 times a day.
Field horsetail. Half a glass of grass is poured with 1000.0 ml of boiling water and infused for 10 minutes, then filtered.	This infusion is recommended for warm sitz baths, the duration of the procedure is 20-30 minutes. Carry out daily until recovery.
Enema with a decoction of lemon balm and oregano. 1 tablespoon of lemon balm + 2 tablespoons of oregano pour 250.0 ml of boiling water and put in a water bath for 20-25 minutes, then insist for 90 minutes.	Enema with a volume of 100 ml, the infusion should be at room temperature. Try to delay the act of defecation as much as possible.
Onion enema, orange peel and aloe. 20 g dried orange peels + 5 g crushed onion+ 8 ml of aloe juice. Stir, pour 50.0 ml hot water(not boiling water), let it brew for 3 hours.	Enema in a volume of 50 ml in a warm form.
Enema with sea buckthorn. Usually, a ready-made pharmacy form of sea buckthorn oil is used.	For an enema use warm oil (not hot). Enter microclysters up to 50 ml.

Acute proctitis with adequate and timely treatment is completely curable. But if the disease has acquired a chronic course, then no methods of treatment lead to a complete recovery. But with the right therapy and diet, you can achieve a long-term remission of the disease and prevent the development of complications.

Prevention

Measures aimed at preventing proctitis and its relapses are to maintain general and local health:

• timely treatment of diseases of the gastrointestinal tract;
• elimination of inflammation in neighboring organs;
• proper nutrition (restriction of fried, fatty, spicy);
• giving up alcohol and smoking;
• observance of thorough hygiene of the anus and genitals;
• the use of barrier contraceptives to prevent transmission of infection during sexual intercourse.

Forecast

Depending on the factors that caused the inflammatory lesion of the rectum, the recovery course started in a timely manner, the prognosis may be different. For example, if proctitis is provoked by an infection, and therapy is started with the onset of initial symptoms in the catarrhal stage, recovery occurs after 10 days.

The prognosis will be doubtful and even unfavorable if the rectum is affected by tuberculosis, Crohn's disease, and also cancer.

The site provides reference information for informational purposes only. Diagnosis and treatment of diseases should be carried out under the supervision of a specialist. All drugs have contraindications. Expert advice is required!

Proctology- This is one of the branches of medicine that studies diseases of both the large intestine and the anus, as well as the pararectal region. The list of these pathologies includes such a disease as proctitis, and it occupies not the last place in terms of the frequency of its occurrence. Moreover, this disease is quite dangerous, as it can provoke the development of a large number of serious complications.

Proctitis - what is it?

The term " proctitis"derived from the word" proktos", which in Greek means " anus". This disease is characterized by inflammation of the rectal mucosa. In most cases, it can be diagnosed along with inflammatory changes in other upstream sections of the intestine. Simultaneously with this pathology, patients can be detected as colitis ( inflammatory disease of the inner lining of the large intestine), and enterocolitis ( inflammation of the small and large intestines), proctosigmoiditis ( inflammation of the mucous membrane of the rectum and part of the sigmoid), as well as other conditions.

Acute proctitis

Occurs in a few hours or days and is accompanied by a superficial lesion of the rectal mucosa. By the nature of the changes in the mucous membrane of the rectum, several types of the acute form of this disease are immediately distinguished, namely:

1. Catarrhal-purulent appearance - characterized by the formation of purulent plaque on the rectal mucosa;
2. Erosive or ulcerative appearance - characterized by the occurrence of erosion or ulceration;
3. Catarrhal-hemorrhagic appearance - accompanied by the formation of point scattered hemorrhages;
4. Polypous view - accompanied by the development of outgrowths in the form of polyps on the rectal mucosa.

Chronic proctitis

Its development can take from several months to several years. This form of this disease is accompanied by a deep lesion of the rectal mucosa. Modern experts offer the following classification of the chronic form of this disease:
1. atrophic appearance - characterized by thinning of the rectal mucosa and smoothing of its folds;
2. Hypertrophic view - accompanied by a thickening of the folds of the mucous membrane, which eventually become loose.

Symptoms of acute proctitis

• Inflammation of the rectum;
• Increase in body temperature;
• Tenesmus ( painful ineffectual urge to defecate);
• Burning and pain in the rectum;
• constipation or diarrhea;
• Bloody discharge during bowel movements.

Symptoms of chronic proctitis

• Mild itching and burning in the rectum;
• Mucous or purulent discharge from the anus;
• An increase in body temperature to subfebrile numbers ( 37 - 38 degrees);
• Mild pain.

Possible complications of the disease

1. Acute paraproctitis - acute inflammation of the tissues surrounding the rectum;
2. Significant decrease in immunity;
3. Sigmoiditis - inflammation of the sigmoid colon;
4. Malignant neoplasms in the rectum.

As you can see, all possible complications are dangerous, so they really should be feared. So, for example, with the development of acute paraproctitis without surgical intervention, it will be impossible to cope with the pathology. To prevent the development of all these conditions, you should consult a proctologist when the very first signs of proctitis occur.

Diagnostics

1. Diagnosis of this disease is carried out using such research methods as:
2. Biopsy - a research method in which cells or tissues are taken from the rectum for further examination under a microscope;
3. Rectoscopy - a research method using a rectoscope, which allows you to establish any changes in the mucous membrane of the rectum;
4. Bacteriological examination of a smear from the wall of the rectum - establishes the flora of this area;
5. Finger examination - is necessary to detail the local signs of the disease.

Treatment

The course of therapy is immediately determined by two factors, namely the form of pathology, as well as the cause of its development.
Treatment includes:

• Strict adherence to a special diet;
• Compliance with the treatment regimen;
• medicinal treatment;
• Hygiene measures;
• Surgical intervention.

Diet

In the event of this disease, the patient is prescribed a special diet, which provides for a complete rejection of alcoholic beverages, spicy, spicy and fried foods. It is recommended to reduce to a minimum the use of all those products that contain a large amount of fiber ( cereals, vegetables and fruits). The main menu should consist of lactic acid products, low-fat varieties meat, as well as soups cooked on low-fat bases.

Drug treatment

Predominantly antibiotic drugs are used to suppress infection. Antibacterial agents are also prescribed, taking into account the sensitivity of pathogens to antibiotics. The selection of an antibiotic, the determination of its dosage, as well as the duration of therapy, are carried out by the attending physician.

Hygiene measures

Locally applied microclysters with a solution collargola or decoction of chamomile. As soon as the inflammatory process subsides a little, it is recommended to use oil microclysters, as well as sitz baths with a 0.01% solution. potassium permanganate. A warm shower also has a beneficial effect on the perineal area. Microclysters should be placed in the morning and before bedtime. Before inserting the tip, first lubricate it with petroleum jelly or sunflower oil.

Mud therapy

Mud procedures are most often carried out in the form of rectal tampons. The application method is often used, which involves applying mud to segmental ( biologically active) zones. Such procedures allow you to increase blood flow at the site of inflammation, expand blood vessels, regulate blood clotting properties, and also strengthen immunity.

Surgical intervention

The operation is performed only if the patient has a narrowing of the intestine due to the appearance of scars in it.

Folk remedies

Recipe #1: take 1st.l. infusion of calendula and mix it with the same amount of 3% boric acid solution. The resulting mixture is used for microclysters. The procedure should be performed every day before going to bed.

Recipe #2: take 2 tbsp. marigold flowers, pour raw materials 1 tbsp. boiled water and place in a water bath. After 15 minutes, remove the broth and leave it to infuse for 45 minutes. We filter and take orally 1 - 2 tbsp. three times a day. At the same time, we use this remedy for enemas - 1 tsp. we dilute the infusion in 1/4 tbsp. water.

Forecast

The prognosis is most often favorable, especially if treatment was started in a timely manner. Chronic proctitis can remind of itself with regular exacerbations, but the frequency of their occurrence can be reduced to a minimum. To do this, you must adhere to a healthy lifestyle and a special diet.

Measures to prevent proctitis

• Timely treatment of pathologies that contribute to its appearance;
• Timely treatment of constipation;
• Refusal to wear synthetic underwear;
• Minimizing the consumption of alcoholic beverages;
• Compliance with the diet after surgical interventions on the rectum;
• Compliance with all rules of intimate hygiene.

The rectum is the lower end of the intestine, ending at the anus. Under the influence of various factors, its mucous membranes can become inflamed, in which case a disease called proctitis develops. Often it is of a combined nature and also affects the sigmoid colon or fatty tissue. The first disease is called - proctosigmoiditis, the second - paraproctitis.

Types and forms of the disease

Proctitis is an inflammatory disease affecting the mucous membrane of the rectal wall. It can occur in a chronic or acute form.

• The chronic form of proctitis has a gradual development. In the presence of this pathology, deeper tissue damage is noted. Her symptoms are not very pronounced, but they bother the patient for a long time. The disease proceeds in waves, periods of exacerbation are followed by periods of remission.
• The acute form of proctitis develops quickly, affecting the surface layers of the mucosa. Symptoms of the disease are pronounced, are permanent, but the patient is disturbed for a short period.

Depending on the changes occurring in the rectum, chronic proctitis is divided into:

1. atrophic. With this pathology, thinning of the mucosa occurs, all the folds of its surface are smoothed.
2. Normotrophic. With it, there are no strong changes in the mucosa, it has a normal appearance.
3. Hypertrophic. In the presence of this type of disease, the mucosa is thickened, its folds are very well expressed.

Depending on the nature of changes in the intestinal mucosa, acute proctitis is divided into:

• Erosive - on the tissues of the intestine there are superficial lesions - erosion.
• Ulcerative - the intestinal mucosa is covered with deeper lesions - ulcers.
• Ulcerative-necrotic - there are ulcers on the tissues of the intestine, in some areas there is necrosis of the mucosa and its rejection.
• Catarrhal-hemorrhagic - the mucous membrane is bright red, edematous, many small hemorrhages are visible on it.
• Catarrhal-mucous - tissues acquire a bright red color, swell, and begin to secrete a lot of mucus.
• Catarrhal-purulent - the tissues are edematous in appearance, pus is present on them.
• Purulent-fibrous - the intestinal tissue is covered with a thin film - purulent-fibrous plaque.
• Polyposis - outgrowths that look like polyps appear on the mucosa.

The most severe is catarrhal-purulent, polyposis, erosive and ulcerative proctitis.

Causes of pathology

Many factors can cause the disease. It can be both very minor damage to the colon, and malignant tumors. Consider the causes of proctitis in more detail:

In addition to the immediate causes of proctitis, there are predisposing factors that do not directly contribute to the development of inflammation, these are:

1. weakened immunity;
2. inflammation in organs located near the rectum - Bladder, prostate, vagina, ovaries, uterus, urethra;
3. hypothermia of the body;
4. frequent colds.

The disease develops with the same frequency in men and women, the risk group includes people who practice non-traditional sex, suffering from diseases of the colon,.

Proctitis may occur in children. It usually occurs in infants under the age of one. Its most common causes are:

• intolerance to the protein that is part of mother's milk or artificial mixtures made on the basis of soy or cow's milk;
• intestinal infections;
• worms;
• dysbacteriosis;
• improper use of rectal suppositories, gas tubes, enemas;
• swallowing by the baby of foreign bodies;
• frequent stool problems.

More often the disease occurs in children who are breastfed. As a rule, sick babies look quite healthy, it is possible to guess about the presence of the disease in them only after examining feces, in which mucus and bloody streaks are present.

Symptoms of inflammation of the rectum

The clinical manifestations of the disease differ and depend on the form.

Signs of acute proctitis:

• discomfort in the anus - heaviness, sensation of a foreign body, burning;
• increasing during defecation;
• pain in the perineum, in women, pain can be given to the vagina, labia, in men to the penis, scrotum;
• pain of a pulling nature in the lower back;
• purulent or bloody discharge from the anus;
• an increase in body temperature, as a rule, no more than 38 degrees;
• increased fatigue, chills;
• frequent urge to defecate, can be painful;
• the presence of blood clots or impurities in the feces;
• or .

Acute proctitis develops quickly, within a few hours or days. It also passes quickly, but with adequate therapy.

Symptoms of chronic proctitis:

• mild pain in the rectum, usually they do not cause much discomfort to the patient;
• mild burning and itching;
• persistent purulent or mucous discharge and anus;
• anemia, pallor of the skin, these signs occur in the presence of chronic bleeding;
• with some types of proctitis, blood impurities in the feces can be observed;
• exhaustion, it develops when the cause of the disease is cancer or other serious pathologies.

Chronic proctitis can occur as a result of improper treatment of acute or initially be an independent disease.

Inflammation of the rectum can spread to surrounding tissues or even organs, leading to the development of extensive pathologies. Proctitis most often leads to the following complications:

• Acute paraproctitis is the transition of the inflammatory process to fatty tissue located near the rectum.
• Chronic paraproctitis with the occurrence of fistulas - purulent inflammation develops in fatty tissue, which causes melting of the affected tissues and the formation of cavities between the intestines and nearby organs, and fistulas often go out.
• , - the pathological process captures the overlying sections of the intestine;
• , cancers - occurs in chronic forms of the disease;
• Scarring of tissues and, as a result, narrowing of the intestinal lumen - pathology usually develops with a severe form of proctitis.
• Dysbacteriosis, decreased general and local immunity.
• Pelvioperitonitis is an inflammation of a thin film lining the abdominal cavity from the inside.

Diagnostic methods

The doctor can assume the presence of proctitis after questioning the patient. However, it is impossible to establish an accurate diagnosis without examinations. For this, they are usually used:

• - allows you to assess the condition of the mucosa, the functioning of the sphincter, to identify intestinal deformities, the presence of secretions;
• rectoscopy - carried out using an instrument with a micro-camera, which allows you to examine the walls of the intestine from the inside and detect any changes on their surface;
• analysis of feces (, for the presence of eggs of worms, bakposev) - this way the presence of worms, pathogens, blood impurities, digestive disorders is detected;
• biopsy - sampling of material is usually carried out during rectoscopy, this is necessary to study the mucosa under a microscope.

Features of treatment

Acute proctitis with timely and proper treatment completely curable. However, if the disease has become chronic, no therapy can lead to a complete recovery. In this case, it is possible to achieve only a long-term remission and prevent the development of complications.

Treatment of proctitis in most cases is carried out using conservative methods. The basis of therapy is diet, medication and the use of enemas, moderate exercise and regimen.

1. Diet. Changing the habitual diet can increase the effectiveness of therapy. With proctitis, a sparing diet is prescribed. All products that can irritate mucous membranes are excluded - sour, salty, spicy, spicy, fatty. In the acute form of the disease and exacerbation of the chronic, sweets, fruits, berries, and vegetables are also excluded. It is recommended to give preference to liquid and semi-liquid dishes, lactic acid products, lean soups, grated lean meat.
2. Medical therapy. The patient can be prescribed different means, the use of certain drugs depends on the form and type of the disease. In acute rectal proctitis, antibiotics are usually used to suppress the development of the infection that caused the disease. First, the contents of the intestine are sown, then, based on its results, a suitable antibacterial drug is selected. In addition to them, antispasmodics, antihistamines are used to relax the intestinal walls. To improve tissue regeneration, relieve symptoms of inflammation, improve metabolic processes, and restore mucous membranes, suppositories can be prescribed. For the treatment of proctitis caused by non-specific ulcerative colitis hormonal preparations are often used.
3. Sitz baths and enemas. As an additional measure, cleansing enemas may be recommended. After them, it is useful to do therapeutic microclysters with decoctions of chamomile or calendula, sea buckthorn or other oils. A good antiseptic effect is obtained by taking sitz baths with a solution of potassium permanganate. It is advisable to do them after each bowel movement.
4. Physical activity and mode. Patients with proctitis are contraindicated for a long stay in a sitting position, as this leads to congestion in the small pelvis, weakening of the pelvic floor muscles. With this disease, it is necessary to perform feasible physical activity. The minimum set of exercises is prescribed even for patients who are indicated for bed rest.

Surgery for proctitis is prescribed in the presence of serious complications. These include.