Causes Of Proctitis And Understanding The Condition

Proctitis is a condition characterized by inflammation of the rectum, often leading to symptoms such as rectal pressure, frequent bowel movements, a persistent urge to defecate, blood in the stool, mucus-filled bowel movements, and the presence of both mucus and blood in the stool. There are multiple potential causes of proctitis, varying from physical irritation to infections and immune-related issues. Understanding these causes can help in diagnosing and treating the condition effectively.

1. Injury From Foreign Objects

One of the less common but significant causes of proctitis is physical damage to the rectal lining due to foreign objects. For instance, improper use of devices such as rectal tubes or excessive reliance on enemas like laxative suppositories can irritate or damage the delicate mucous membranes of the rectum, potentially leading to inflammation.

2. Bacterial Or Parasitic Infections

Infections are among the most common causes of proctitis. Chronic bacterial infections such as shigellosis (bacillary dysentery) and parasitic conditions like amebiasis (amebic dysentery) frequently involve rectal inflammation. These infections can cause ulceration and irritation in the rectum, resulting in the typical symptoms of proctitis.

3. Sexually Transmitted Infections (STIs)

Sexually transmitted diseases, particularly those that affect the anal and rectal areas, can also cause proctitis. Infections such as gonorrhea, syphilis, chlamydia, and herpes simplex virus (HSV) may lead to rectal inflammation, especially in individuals practicing anal intercourse without proper protection.

4. Autoimmune And Immune-Mediated Conditions

Some individuals develop proctitis due to an overactive or weakened immune response. Conditions such as Inflammatory Bowel Disease (IBD), including Crohn's disease and ulcerative colitis, may involve the rectum and cause chronic inflammation. Additionally, immunosuppressed individuals are more prone to opportunistic infections that can lead to proctitis.

5. Associated Skin And Anorectal Conditions

Other medical conditions affecting the anal region can also contribute to rectal inflammation. For example, anal fissures, anal fistulas, and hidradenitis suppurativa — a chronic skin condition involving painful lumps under the skin — can cause local irritation and extend inflammation to the lower rectum.

6. Schistosomiasis (Blood Fluke Infection)

In certain parts of the world, particularly in tropical and subtropical regions, parasitic infections like schistosomiasis are a known cause of proctitis. This disease, caused by parasitic worms, can lead to intestinal and rectal damage over time, contributing to chronic inflammation.

7. Radiation-Induced Proctitis

Individuals undergoing radiation therapy for cancers in the pelvic region, such as prostate, cervical, or rectal cancer, may develop inflammation of the rectum as a side effect. This is known as radiation proctitis and can be either acute or chronic depending on the treatment duration and individual response.

8. Antibiotic-Associated Colitis

Certain antibiotics can disrupt the natural balance of gut bacteria, leading to an overgrowth of harmful bacteria such as Clostridioides difficile (C. diff). This imbalance can cause colitis and, in some cases, affect the rectum, resulting in a condition known as antibiotic-associated proctitis.