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Treatments and drugs
By Mayo Clinic staffTreatment for proctitis depends on the underlying cause of the inflammation.
Treatment for proctitis caused by an infection
Your doctor may recommend medications to alleviate the cause of your infection. Options may include:
- Antibiotics. For proctitis caused by bacterial infections, your doctor may recommend an antibiotic.
- Antivirals. For proctitis caused by viral infections, such as the sexually transmitted virus herpes, your doctor may prescribe an antiviral medication.
Treatment for proctitis caused by radiation therapy
Mild cases of radiation proctitis may not require treatment. In other cases, radiation proctitis can cause severe pain and bleeding that requires treatment. Your doctor may recommend treatments such as:
- Medications. Anti-inflammatory drugs such as sucralfate can be administered in pill, suppository or enema form. These medications can help control inflammation and reduce bleeding.
- Stool softeners and dilation can help open up obstructions in the bowel.
- Treatment to destroy damaged tissue. 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 beam of light (laser) inserted in the rectum to burn away lesions, while APC uses a jet of argon gas along with an electric current.
Proctitis caused by inflammatory bowel disease
Treatment of proctitis related to Crohn's disease or ulcerative colitis is aimed at reducing the inflammation in your rectum. Treatment may include:
- Medications to control rectal inflammation. Your doctor may prescribe anti-inflammatory medications, such as mesalamine (Asacol, Canasa, others) or corticosteroids. These drugs are available in pill, suppository or enema form. Steroid suppositories or enemas may ease inflammation in your rectum. Inflammation in people with Crohn's disease often requires treatment with a medication that suppresses the immune system, such as infliximab (Remicade).
- 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.
Eosinophilic proctitis
Removing different nutrients from the diet, and then reintroducing them later, is an effective treatment strategy for this problem.
- Proctitis. National Institute for Diabetes and Digestive and Kidney Diseases. http://digestive.niddk.nih.gov/ddiseases/pubs/proctitis/index.htm. Accessed May 1, 2012.
- Marx JA, et al. Rosen's Emergency Medicine: Concepts and Clinical Practice. 7th ed. Philadelphia, Pa.: Mosby Elsevier; 2010. http://www.mdconsult.com/books/about.do?about=true&eid=4-u1.0-B978-0-323-05472-0..X0001-1--TOP&isbn=978-0-323-05472-0&uniqId=230100505-57. Accessed May 1, 2012.
- Hoentjen F, et al. Infectious proctitis: When to suspect it is not inflammatory bowel disease. Digestive Diseases and Sciences. 2012; 57:269.
- Nostrant TT, et al. Clinical features, diagnosis, and treatment of radiation proctitis. http://www.uptodate.com/home/index. Accessed May 1, 2012.
- Burger D, et al. Conventional medical management of inflammatory bowel disease. Gastroenterology. 2011;140:1827.
- Feldman M, et al. Sleisenger & Fordtran's Gastrointestinal and Liver Disease: Pathophysiology, Diagnosis, Management. 9th ed. Philadelphia, Pa.: Saunders Elsevier; 2010. http://www.mdconsult.com/books/about.do?eid=4-u1.0-B978-1-4160-6189-2..X0001-7--TOP&isbn=978-1-4160-6189-2&about=true&uniqId=229935664-2192. Accessed May 1, 2012.
- Picco MF (expert opinion). Mayo Clinic, Jacksonville, Fla. May 9, 2012.
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