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Treatments and drugs
By Mayo Clinic staffProctitis treatment depends on the cause.
Infectious proctitis
Your doctor is likely to prescribe medications to alleviate the cause of your infection. The specific medication depends on the cause of your infection.
- Antibiotics. For bacterial STDs, the antibiotic depends on the STD. For non-sexually transmitted infections, your doctor will likely prescribe an oral antibiotic. For proctitis caused by antibiotic use, your doctor may prescribe metronidazole (Flagyl) or vancomycin (Vancocin) to destroy harmful bacteria that have developed in place of normal intestinal bacteria.
- Antivirals. For viral STDs, such as herpes-related proctitis, your doctor may prescribe an antiviral medication, such as acyclovir (Zovirax). If taken within 48 hours, antiviral medication may lessen pain and shorten the duration of signs and symptoms.
Radiation proctitis
The most common cause of noninfectious proctitis is a side effect from radiation treatment to the pelvis. Mild signs and symptoms may require no treatment. However, more severe cases, particularly those involving bleeding, may need treatment:
- Iron supplements. Chronic bleeding from proctitis can cause iron deficiency anemia. Taking iron supplements may help restore your iron levels to normal and reduce this type of anemia once your bleeding has stopped or diminished. If anemia persists despite iron therapy, you may need ablation therapy.
- Ablation therapy. These techniques improve proctitis symptoms by destroying abnormal, bleeding tissue. Ablation procedures used to treat proctitis include laser therapy and argon plasma coagulation (APC). Laser therapy uses a hot beam of light (laser) inserted to burn away lesions, while APC uses a jet of argon gas along with an electric current.
Proctitis caused by inflammatory bowel disease
Proctitis related to Crohn's disease or ulcerative colitis may require ongoing treatment of the underlying condition. The goal of treatment is to reduce the inflammation that causes the signs and symptoms.
- Anti-inflammatory medications. Your doctor may prescribe corticosteroids or other anti-inflammatory agents, such as sulfasalazine (Azulfidine) or mesalamine (Asacol, Rowasa, others), in pill, suppository or enema form. Steroid suppositories or enemas may ease inflammation in your rectum.
- Anti-diarrheals. If you have diarrhea, your doctor may prescribe a fiber supplement, such as psyllium powder (Metamucil) or methylcellulose (Citrucel), to add bulk to your stool. Your doctor may suggest loperamide (Imodium) or a combination of diphenoxylate and atropine (Lomotil). However, these drugs may cause serious side effects, such as colon dilation and rupture, especially if taken over time or in high doses. Talk to your doctor before using these treatments.
- Surgery. If drug therapy doesn't relieve your signs and symptoms, your doctor may recommend surgery to remove a damaged portion of your digestive tract.
