Under a proctitis refers to the inflammation of the rectum during infection, inflammatory bowel diseases, or after radiation therapy. The symptoms include rectal discomfort and bleeding. The diagnosis is made by a sigmoidoscopy, often creating cultures and biopsies. The treatment depends on the etiology.

(See also Clarification of Anorektalkrankheiten.)

Under a proctitis refers to the inflammation of the rectum during infection, inflammatory bowel diseases, or after radiation therapy. The symptoms include rectal discomfort and bleeding. The diagnosis is made by a sigmoidoscopy, often creating cultures and biopsies. The treatment depends on the etiology. (See also the clarification of Anorektalkrankheiten.) Proctitis may be a manifestation of sexually transmitted diseases (eg. B. Neisseria gonorrhoeae, Chlamydia sp) Certain intestinal infections (eg. As Campylobacter, Shigella, Salmonella, Introduction to Gram-negative rods) inflammatory bowel disease irradiations , Proctitis with prior use of antibiotics can arise due to Clostridium difficile. Sexually transmitted pathogens cause more common in men who have sex with men, proctitis. Compromised immune patients have an increased risk of herpes simplex and cytomegalovirus infections. Typically, symptoms and complaints give patients tenesmus (a strong need to empty the Dar when no chair is available), rectal bleeding and retirement of mucus as complaints. Proktitiden with gonorrhea, herpes simplex or cytomegalovirus can cause severe anorectal pain. Diagnosis Proctoscopy or sigmoidoscopy tests for sexually transmitted diseases and to C. difficile diagnosis of proctitis have to perform a Proctoscopy or sigmoidoscopy showing an inflamed rectum. In the presence of small ulcers and sores suspected of a herpes infection. Rectal swabs should be tested for Neisseria gonorrhoeae and Chlamydia sp. (By culture or ligase chain reaction), intestinal pathogens (by means of culture) and viral pathogens (by culture or immunoassay). Serological testing method for the diagnosis of syphilis and stool tests for C. difficile toxin be performed. Under certain circumstances, a mucosal biopsy is required. In addition, a colonoscopy may be indicated in some patients to rule out inflammatory bowel disease. Therapy Various treatments depending on the cause Infectious proctitis can be treated with antibiotics. Men who have sex with men and the traffic nonspecific proctitis may empirically with ceftriaxone 125 mg i.m. 1 times a day (or ciprofloxacin 500 mg po 2 times daily for 7 days) plus doxycycline 100 mg po be treated 2 times a day for 7 days. The antibiotic-associated proctitis is with metronidazole (250 mg p.o. 4 times daily) or vancomycin (125 mg p.o. 4 times daily) for 7-10 days. A radiation proctitis is carefully applied generally effective with topical formalin to the affected mucosa treated. Alternative treatments are topical Kortikosteroidschaumbehandlung (hydrocortisone 90 mg) or enemas (hydrocortisone 100 mg or methylprednisolone 40 mg) 2 times for 3 weeks or mesalamine enema daily (4 g) at bedtime for 3-6 weeks. A therapy with 500 mg Mesalaminz├Ąpfchen 1 or 2 times daily, mesalamine 800 mg p.o. 3 times daily or sulfasalazine 500-1000 mg po 4 times daily for ? 3 weeks, as mono or combination therapy with topical application can also be effective. Patients who do not respond to this approach may benefit from treatment with systemic corticosteroids. Different methods of coagulation have been tried, including argon plasma, laser, electrical and thermal coagulation.

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