Proctitis - Altmeyers Encyclopedia - Department Dermatology

Synonym(s)

rectal inflammation

Definition
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Acute or chronic, specific or non-specific inflammation of the mucous membrane of the rectum.

Etiopathogenesis
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trauma, food, drugs or toxic substances, hemorrhoids, ulcerative colitis, enteritis, rectal gonorrhoea, vegetative dysregulation, candidiasis, worm infestation, radiating, STD etc.

Clinical features
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Dull pressure or pain in the anal and rectal area, usually combined with urge to defecate up to tenesmus. The symptoms are generally more severe before bowel movement and improved after bowel movement. Frequently serous, purulent or purulent blood secretion from the anus.

Therapy
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Cryptitis and papillitis: For milder forms of cryptitis and papillitis, conservative treatment is recommended. This can often lead to healing or improvement. Treatment with suppositories containing bismuth(e.g. Eulatin N suppositories).
If the patient is resistant to therapy, the crypts can be touched through a spreading speculum with hook probes or thin cotton wool supports. Filling the diseased crypts several times with antiphlogistic ointments (e.g. Faktu ointment) has a favourable effect. The ointments can be distilled through a blunt cannula (according to Hein) bent like a walking stick into the crypts placed in the speculum. If a conservative procedure does not lead to success, a surgical procedure is necessary. Remove papillae with diathermy loop in LA, open inflamed crypts. Follow-up treatment with lukewarm chamomile sit-baths 1-3 times/day (15 trp. chamomile concentrate on 2-3 l water) for 4-10 days. Ointment therapy with a liver trans ointment (e.g. Unguentolan).
Non-specific haemorrhagic rectitis and proctitis (minus variant of ulcerative colitis?): Local therapy with sulfasalazine supplement 2 times 1000 mg (azulfidines 3 times 2 supplements) and Salofalk klysmes or rectal foam (claversal rectal foam).
Alternatively: 5-ASA e.g. Mesalazine (Claversal) 2 times/day 500 mg p.o.
For severe forms additional sulfasalazine 2-3 g/day (Azulfidine Drg. 2-3 times/day 2 Drg. spread over the day).
Radiation rectitis: Frequent consequence of radiological therapies of the bladder, prostate, intestine and female genitals. Rectitic areas are often sharply defined. Warm retention enemas with rutin derivatives have proved to be effective in this case. For this purpose, the contents of 3 or 4 sliced capsules (e.g. sclerovenol or Rutin Kps.) are dissolved in 60-120 ml water.