Proctitis

Inflammation of the rectal mucosa, often extending to the anal canal, characterized by erythema, edema, friability, and possible ulceration, typically presenting with rectal pain, bleeding, tenesmus, and mucous discharge.

Causes

• Sexually transmitted infections

  • Gonorrhea

  • Chlamydia trachomatis

  • Lymphogranuloma venereum (LGV)

  • Herpes simplex virus (HSV)

  • Syphilis

  • Mpox (monkeypox virus)

• Bacterial, viral, or parasitic enteric infections

  • Salmonella

  • Shigella

  • Campylobacter

  • Clostridioides difficile

• Inflammatory bowel disease

  • Ulcerative colitis

  • Crohn's disease involving the rectum

• Radiation and treatment-related causes

  • Pelvic radiotherapy

  • Radiation-induced proctitis

  • Chemotherapy-associated mucosal injury

• Traumatic and mechanical causes

  • Rectal trauma

  • Instrumentation or endoscopic procedures

  • Foreign body injury

• Chemical and irritant causes

  • Enema-related irritation

  • Rectal medications causing mucosal injury

  • Chemical exposure

• Allergic and immune-mediated causes

  • Food allergy (especially in infants)

  • Cow's milk protein allergy

  • Soy-based formula allergy

  • Eosinophilic gastrointestinal disorders

• Other causes

  • Ischemic proctitis

  • Diversion proctitis after fecal stream diversion

  • Solitary rectal ulcer syndrome