Summary about Disease
Ulcerative proctitis is a form of ulcerative colitis (UC) that affects only the rectum. It causes inflammation and ulcers (sores) in the lining of the rectum. This can lead to symptoms like rectal bleeding, diarrhea, and urgency to defecate. While it's a localized condition, if left untreated, it can sometimes spread to involve more of the colon.
Symptoms
The most common symptoms of ulcerative proctitis include:
Rectal bleeding
Rectal pain
A feeling of urgency to have a bowel movement
Feeling like you need to have a bowel movement even when your bowels are empty (tenesmus)
Diarrhea, possibly with mucus or pus
Pain on the left side of the abdomen
Incontinence
Some people may also experience fatigue
Causes
The exact cause of ulcerative proctitis is unknown. It is believed to be an autoimmune disorder, where the body's immune system mistakenly attacks the lining of the rectum. Genetics and environmental factors may also play a role. Specific triggers are difficult to pinpoint, and it is not caused by diet or stress, although these factors can worsen symptoms.
Medicine Used
4. Medicine used Medications used to treat ulcerative proctitis typically aim to reduce inflammation and control symptoms. Common options include:
Aminosalicylates (5-ASAs): These are often the first-line treatment and can be administered topically (suppositories or enemas) or orally. Examples include mesalamine, sulfasalazine, balsalazide, and olsalazine.
Corticosteroids: These are used to reduce inflammation but are generally for short-term use due to potential side effects. They can also be given topically (enemas or suppositories) or orally. Examples include hydrocortisone and prednisone.
Immunomodulators: These medications suppress the immune system and are used for people who don't respond to other treatments or to maintain remission. Examples include azathioprine and 6-mercaptopurine.
Biologics: These are medications that target specific proteins involved in the inflammatory process. They are typically used when other treatments have failed. Examples include infliximab, adalimumab, golimumab, vedolizumab, and ustekinumab.
Tofacitinib: A Janus kinase (JAK) inhibitor, which also suppresses the immune system.
Is Communicable
No, ulcerative proctitis is not communicable. It is not an infectious disease and cannot be spread from person to person through contact.
Precautions
While there's no way to entirely prevent ulcerative proctitis, certain lifestyle adjustments and precautions may help manage symptoms and prevent flare-ups:
Follow your doctor's treatment plan: This is the most important step in managing the condition.
Manage stress: Stress can worsen symptoms, so practice stress-reduction techniques like yoga, meditation, or deep breathing exercises.
Dietary modifications: While diet doesn't cause ulcerative proctitis, some people find that certain foods trigger their symptoms. Keeping a food diary to identify and avoid trigger foods can be helpful. Common trigger foods include dairy, spicy foods, alcohol, and caffeine.
Stay hydrated: Diarrhea can lead to dehydration, so drink plenty of fluids.
Quit smoking: Smoking can worsen symptoms.
Get regular exercise: Exercise can help reduce stress and improve overall health.
How long does an outbreak last?
The duration of an ulcerative proctitis outbreak can vary significantly from person to person. Some individuals may experience symptoms for a few days or weeks, while others may have chronic, relapsing-remitting symptoms that persist for months or even years. With effective treatment, many people can achieve remission, where they experience little to no symptoms.
How is it diagnosed?
Diagnosis typically involves a combination of:
Medical history and physical exam: The doctor will ask about your symptoms and medical history.
Blood tests: To check for inflammation, anemia, and other signs of infection.
Stool tests: To rule out infections and check for blood in the stool.
Sigmoidoscopy or Colonoscopy: A flexible tube with a camera is inserted into the rectum to visualize the lining of the rectum and colon. Biopsies (tissue samples) can be taken during the procedure to confirm the diagnosis and rule out other conditions.
Fecal Calprotectin test: Checks for inflammation in the intestines using a stool sample
Timeline of Symptoms
9. Timeline of symptoms The timeline of symptoms can vary. Some individuals may experience a sudden onset of symptoms, while others may have a more gradual development over time. The disease course can be:
Acute: Symptoms start suddenly and severely.
Chronic Intermittent: Symptoms come and go, with periods of remission (no symptoms).
Chronic Continuous: Symptoms are always present to some degree. It's important to note that symptom severity and frequency can fluctuate over time.
Important Considerations
Increased risk of colon cancer: People with ulcerative proctitis, especially if it extends beyond the rectum, have an increased risk of colon cancer. Regular colonoscopies are recommended for surveillance.
Potential for progression: While ulcerative proctitis is initially confined to the rectum, it can sometimes spread to involve more of the colon (extensive colitis). Regular monitoring by a gastroenterologist is crucial.
Importance of adherence to treatment: Consistent use of prescribed medications is essential to control inflammation, prevent flares, and maintain remission.
Psychological impact: Living with a chronic condition like ulcerative proctitis can have a significant psychological impact, leading to anxiety, depression, and social isolation. Seeking support from a therapist or support group can be helpful.
Fertility: Some medications for ulcerative proctitis can affect fertility in both men and women. It's important to discuss these concerns with your doctor if you are planning to have children.