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Infectious Proctitis: When to Suspect It Is Not Inflammatory Bowel Disease

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Abstract

Background

Proctitis is a common problem and is most frequently associated with inflammatory bowel diseases. However, the incidence of infectious proctitis appears to be rising, especially in men who have sex with men. This may be due to the rise of people participating in receptive anal sex as well as the increase in sexually transmitted infections. The most frequently reported pathogens include Neisseria gonorrhoeae, Chlamydia trachomatis, Treponema pallidum, and herpes simplex.

Diagnosis

Symptoms of infectious proctitis can include rectal blood and mucous discharge, anorectal pain, ulcers, and occasionally lymphadenopathy and fever. History and physical examination are crucial in establishing a diagnosis, supported by endoscopy, histology, serology, culture and PCR.

Treatment

Treatment with antibiotics or antivirals is usually initiated, either empirically or after establishing a diagnosis. Co-infections, HIV testing, and treatment of sexual partners should always be considered.

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Authors and Affiliations

  1. Inflammatory Bowel Disease Center, University of Chicago Medical Center, 5841 S. Maryland Avenue, MC4076, Chicago, IL, 60637, USA

    Frank Hoentjen & David T. Rubin

  2. Department of Gastroenterology, Vrije Universiteit, Amsterdam, The Netherlands

    Frank Hoentjen

Authors
  1. Frank Hoentjen
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  2. David T. Rubin
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Corresponding author

Correspondence to David T. Rubin.

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Hoentjen, F., Rubin, D.T. Infectious Proctitis: When to Suspect It Is Not Inflammatory Bowel Disease. Dig Dis Sci 57, 269–273 (2012). https://doi.org/10.1007/s10620-011-1935-0

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  • DOI: https://doi.org/10.1007/s10620-011-1935-0

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