Proctitis
Alerts and Notices
Synopsis
Proctitis often occurs in adults with receptive anal exposures (oral, digital, or genital to anal). Neisseria gonorrhoeae, Chlamydia trachomatis (including lymphogranuloma venereum [LGV] serovars), herpes simplex virus (HSV), and Treponema pallidum are the most common sexually transmitted pathogens. Proctitis can also be caused by nonsexually transmitted infections, autoimmune diseases, ischemia, vasculitis, trauma, radiation (see radiation proctitis), or medication side effects. In addition, it can affect adults with inflammatory bowel disease (eg, Crohn disease, ulcerative colitis).
Treatment depends on the cause and ranges from antibiotic or antiviral therapy to anti-inflammatory or immunosuppressive therapy.
Codes
ICD10CM:K62.89 – Other specified diseases of anus and rectum
SNOMEDCT:
3951002 – Proctitis
Look For
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Diagnostic Pearls
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Differential Diagnosis & Pitfalls
Etiologies of proctitis:- Inflammatory bowel disease (Crohn disease, ulcerative colitis)
- Anal trauma
- Infection – sexually and nonsexually transmitted infections, such as Salmonella, Shigella, Campylobacter, Escherichia coli, Clostridioides (formerly Clostridium) difficile, or amebiasis
- Radiation proctitis
- Ischemic colitis
- Anorectal malignancy (see anal cancer, rectal carcinoma)
- Anal fissure
- Thrombosed internal or external hemorrhoids
- Microscopic colitis
- Irritable bowel syndrome – colonoscopy with biopsies will be normal
Best Tests
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Management Pearls
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Therapy
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Drug Reaction Data
Below is a list of drugs with literature evidence indicating an adverse association with this diagnosis. The list is continually updated through ongoing research and new medication approvals. Click on Citations to sort by number of citations or click on Medication to sort the medications alphabetically.Subscription Required
References
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Last Reviewed:08/17/2021
Last Updated:08/22/2021
Last Updated:08/22/2021