Proctosigmoiditis: Everything you need to know

Proctosigmoiditis is a type of ulcerative colitis typically treated with different medicines including anti-inflammatory medicines.

What causes proctosigmoiditis is unknown, but may be linked to genetic and environmental factors.

Keep on reading to learn more about possible causes, risk factors and proctosigmoiditis remedies.

Causes

proctosigmoiditis woman
Genetic and environmental factors could contribute to the risk of proctosigmoiditis in a person.

Proctosigmoiditis, an inflammatory bowel disease, is a type of ulcerative colitis. Symptoms are caused by inflammation of the large intestines. What causes it inflammation is not clear but a number of factors may play a role.

An overactive immune system, for example, can cause ulcerative colitis. In some individuals, some bacterial strains can mistakenly cause the immune system to attack the large intestine. It causes inflammation, and can lead to proctosigmoiditis symptoms.

Ulcerative colitis often tends to run for families, so another possible reason why proctosigmoiditis may develop is the genes of an individual.

Environmental factors can also increase the risk of proctosigmoiditis, including:

  • oral contraceptives
  • antibiotic medications
  • high fat diet.

Treatment

Although there is no remedy for the disease, the symptoms may be controlled. Proctosigmoiditis therapies usually include medicine, surgery or a combination of both.

Many people with proctosigmoiditis will need to take medication for their lifetime to control the symptoms and prevent serious complications.

While there is currently no cure for the disease, medications help reduce proctosigmoiditis symptoms, prevent serious complications and improve quality of life.

Doctors may prescribe five types of medications:

  • Aminosalicylates: These are anti-inflammatory drugs, such as mesalamine. They come in both topical and oral forms. Unless symptoms are extensive when a doctor first diagnoses the condition, people usually try topical forms first. Typically, these are the first type of medication prescribed for proctosigmoiditis.
  • Corticosteroids: Doctors may also prescribe these drugs in either topical or oral forms to treat or prevent inflammation if necessary.
  • Immunomodulators: This is a class of drugs that reduces the activity of the immune system, such as methotrexate. Immunomodulators are only necessary if other medications are not working.
  • Biologics: These are a newer class of drugs that target tumor necrosis factor, a protein involved in inflammation. Examples of biologics include golimumab and infliximab.
  • Other medications: Other medications may occasionally be necessary to deal with specific symptoms or complications, such as antibiotics for treating infections.

There are different ways to take these medicines, which can depend on the symptoms location and severity.

Many medications, for example, come in the form of an enema, which injects the drug into a liquid or foam form through an applicator that an individual implants into the rectum. In other situations, it might be through the mouth or through a suppository.

Bowel surgery is an choice in more severe cases of proctosigmoiditis. This may include completely removing the last portion of the colon (large intestine) and the rectum or big intestine.

Changes in lifestyle can help people with proctosigmoiditis, too. This can include regular exercise, maintaining a healthy diet, avoiding smoking tobacco and reducing stress.

Possible complications

People with proctosigmoiditis might encounter complications including:

  • Rectal bleeding: This occurs when ulcers in the rectum open up, causing bleeding.
  • Anemia: Blood loss from rectal bleeding can lead to anemia. This is a condition in which the body lacks enough red blood cells to function normally.
  • Dehydration: The large intestines may become unable to absorb fluids properly, which can cause dehydration.
  • Malabsorption and nutrient deficiencies: The large intestines can also stop fully absorbing nutrients. Over time, this can lead to nutrient deficiencies.
  • Megacolon: This is where inflammation reaches deeper layers of the large intestines. It can be life threatening and require immediate treatment.
  • Cancer: People with ulcerative colitis may be more likely to develop colon cancer. Several studies show that the risk increases over time. For example, someone with the condition for 10 years has around a 2% greater risk, but after 30 years, it increases to around 18%.

Risk factors

Possible risk factors for proctosigmoiditis include:

  • having a family history of inflammatory bowel disease
  • smoking
  • being between 15–30 years old or over 60 years
  • being of Ashkenazi Jewish descent

When to see a doctor

If a person is having diarrhea that lasts longer than a few days, it is worth seeing a doctor. This is especially important when there is diarrhea with bleeding, fever or severe pain in the stomachs.

A medical assessment will involve a detailed discussion of a person’s medical history, family history, symptoms and physical examination.

A colonoscopy would likely involve additional examination. This involves feeding into the large intestines through a long, flexible camera through the rectum. Also, doctors may suggest other tests, such as blood or stubble tests.

Summary

Proctosigmoiditis is a type of ulcerative colitis that affects the large intestines and the rectum.

It can be the result of an overactive immune system, genetics or factors in the environment. Individuals with a family history of the disease face an increased risk of developing it themselves.

Although it is a lifelong condition, there are several types of medication available to treat the symptoms. Surgery may be necessary in the more severe cases.

Complications can range from rectal bleeding to a higher risk of colon cancer, so they should talk to a doctor if a person suspects they may have the condition.

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