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Ulcerative Proctitis

What is ulcerative proctitis?
Ulcerative proctitis is characterized by inflammation, redness, and ulcerations of the lining of the rectum (the rectum is the last six inches of the large intestine). The word “ulcerative” is used because the disease actually causes the formation of sores/ulcers on the inner lining of the rectum. The cause of ulcerative proctitis is unknown.

What are the symptoms of ulcerative proctitis?
The symptoms associated with ulcerative proctitis include: 

  • Diarrhea
  • Bleeding 
  • Tenesmus (a persistent urge to empty the bowel whether or not stool is present)
  • Mucus discharge
  • Rectal pain
  • Accidental Bowel Leakage

Patients may notice the passage of blood or mucus with or without stool. The amount of bleeding from ulcerative proctitis is usually small, but it can appear to be a lot and can be frightening. All of these symptoms can occur without warning at any time during the day or night.

What causes ulcerative proctitis?
Researchers are actively trying to find its cause. Many scientists now believe that it is due to a reaction of the body’s immune system which results in an inflammation of the lining of the rectum. Although the cause of ulcerative proctitis has not been identified, it is known that dietary habits or stress do not cause it. However, people with the disease may find that busier, more stressful times aggravate their symptoms. Ulcerative proctitis is not contagious and cannot be transmitted from one person to another.

How is ulcerative proctitis detected?
Your doctor can detect this disease by a visual exam of the lining of your rectum using an instrument called a flexible sigmoidoscope (a lighted, flexible tube about the thickness of a finger). This examination is important because the symptoms of proctitis may be the same as the symptoms of many other diseases, some of which are quite serious.

How is ulcerative proctitis treated?
The treatment of ulcerative proctitis depends on the extent of the inflammation and the number of flareups you have had. For mild inflammation medicated enemas, suppositories, or foam are usually prescribed. If this is your first flare-up, the medication is stopped once the inflammation is gone. If the inflammation becomes more severe, oral medication may also be prescribed. Patients with repeated episodes are often prescribed oral medication to reduce the chance of further episodes. Regular examinations are important for monitoring your disease and staying current with the best approaches for ongoing care of your ulcerative proctitis. In addition to medication, changes in diet may be helpful. A high-fiber diet and plenty of water is helpful. Patients with diarrhea often find that avoiding milk and milk products, spicy foods, and raw fruits and vegetables will improve the diarrhea. If you have questions about how to change your diet, ask your doctor. Regular visits with the doctor are important to adjust your medication as your symptoms change. Patients who participate actively in learning how to manage their disease find the quality of their life improves.

What can I expect?
You can expect to lead a normal, active life. Symptoms will vary from person to person. Some people have symptoms constantly. In others, ulcerative proctitis may be inactive for months or even years and then flare up without warning. Regardless of your symptoms pattern, you will need regular follow-ups with your physician to monitor changes in the disease and adjust your medications. The chances that ulcerative proctitis will spread to involve the colon (become ulcerative colitis) are slim (10-20%). Ulcerative proctitis does not significantly increase your risk of developing cancer.

What can I do to improve my condition?
You can do certain things which may make your disease easier to live with.

  • Increase the amount of fiber in your diet either through high-fiber foods or commercial fiber supplements.
  • Avoid dairy products. A lactose-free diet can help to control symptoms of cramping, gas, diarrhea or abdominal bloating. Lactose is a sugar found in dairy products. However, you can now buy lactose-free milk, yogurt, and ice cream, as well as products that counteract lactose in dairy products.
  • Decrease stress. Stress and tension can make your symptoms worse. Relaxation techniques and changes in lifestyle may help.
  • Talk to someone who is experiencing the same symptoms. The local chapter of the Crohn’s and Colitis Foundation of America (CCFA) is an excellent resource. The number for the local chapter is 651-917-2424. The number for the national organization is 800-932-2423. For further information their website address is