Proctocolitis
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [2]; Associate Editor(s)-in-Chief: Qasim Salau, M.B.B.S., FMCPaed [3]
Overview
Proctocolitis is a general term for inflammation of the rectum and colon particularly distal part of the colon(sigmoid)[1]. Common causes of proctocolitis include Chlamydia trachomatis, Lymphogranuloma Venereum, Neisseria gonorrhoeae, HSV, and Campylobacter species. The mainstay of therapy for infectious proctocolitis is antimicrobial therapy. The preferred regimen is a combination of Ceftriaxone and Doxycycline. Proctocolitis may be acute or chronic.
Historical Perspective
Classification
There is no established classification system for proctocolitis. However, it may be classified based on etiology, age and duration of symptom.
Classification by etiology
- Infectious
- Viral
- Bacterial
- Fungal,
- Protozoan
- Atypical micro-organism.
- Allergic (eosinophilic)
- Vascular
- Autoimmune
- Drug-induced
- Radiation
- Chemical
- Idiopathic
Classification by Age
Classification by duration of symptoms
- Acute: for example allergic proctocolitis in infants.
- Chronic: Usually months to years, for example ulcerative colitis.
Pathophysiology
The exact pathophysiology of proctolcolitis is not fully understood. However, several mechanisms are hypothesized to play a role in the pathogenesis.[2][3][4][5][6][7][8]
Pathogenesis
Causes
Proctocolitis has many possible causes. Common infectious causes of proctocolitis include Chlamydia trachomatis, LGV (Lymphogranuloma Venereum), Neisseria gonorrhoeae, HSV, and Campylobacter species. It can also be idiopathic (see colitis), vascular (as in ischemic colitis), or autoimmune (as in inflammatory bowel disease).
Life Threatening Causes
Common Causes
Causes by Organ System
| Cardiovascular | No underlying causes |
| Chemical/Poisoning | No underlying causes |
| Dental | No underlying causes |
| Dermatologic | No underlying causes |
| Drug Side Effect | Chlorpropamide |
| Ear Nose Throat | No underlying causes |
| Endocrine | No underlying causes |
| Environmental | No underlying causes |
| Gastroenterologic | No underlying causes |
| Genetic | No underlying causes |
| Hematologic | No underlying causes |
| Iatrogenic | No underlying causes |
| Infectious Disease | No underlying causes |
| Musculoskeletal/Orthopedic | No underlying causes |
| Neurologic | No underlying causes |
| Nutritional/Metabolic | No underlying causes |
| Obstetric/Gynecologic | No underlying causes |
| Oncologic | No underlying causes |
| Ophthalmologic | No underlying causes |
| Overdose/Toxicity | No underlying causes |
| Psychiatric | No underlying causes |
| Pulmonary | No underlying causes |
| Renal/Electrolyte | No underlying causes |
| Rheumatology/Immunology/Allergy | No underlying causes |
| Sexual | No underlying causes |
| Trauma | No underlying causes |
| Urologic | No underlying causes |
| Miscellaneous | No underlying causes |
Causes in Alphabetical Order
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Differentiating Proctocolitis from Other Diseases
Epidemiology and Demographics
Risk Factors
Screening
Natural History, Complications, and Prognosis
Natural History
Complications
Prognosis
Diagnosis
Diagnostic Criteria
History and Symptoms
Physical Examination
Laboratory Findings
Imaging Findings
Other Diagnostic Studies
Treatment
Medical Therapy
- All patients with proctocolitis should be treated.
- Treatment of proctocolitis is similar to that of proctitis.
- Generally, the following regimen is recommended:
- Preferred regimen: Ceftriaxone 250 mg IM AND Doxycycline 100 mg PO bid for 7 days
To view additional treatment and special considerations for the management of proctitis/proctocolitis, click here.
Surgery
Prevention
See also
References
- ↑ Online Medical dictionary[1]
- ↑ 2.0 2.1 Nowak-Węgrzyn A (2015). "Food protein-induced enterocolitis syndrome and allergic proctocolitis". Allergy Asthma Proc. 36 (3): 172–84. doi:10.2500/aap.2015.36.3811. PMC 4405595. PMID 25976434.
- ↑ 3.0 3.1 Pumberger W, Pomberger G, Geissler W (2001). "Proctocolitis in breast fed infants: a contribution to differential diagnosis of haematochezia in early childhood". Postgrad Med J. 77 (906): 252–4. PMC 1741985. PMID 11264489.
- ↑ 4.0 4.1 Alfadda AA, Storr MA, Shaffer EA (2011). "Eosinophilic colitis: epidemiology, clinical features, and current management". Therap Adv Gastroenterol. 4 (5): 301–9. doi:10.1177/1756283X10392443. PMC 3165205. PMID 21922029.
- ↑ Do NL, Nagle D, Poylin VY (2011). "Radiation proctitis: current strategies in management". Gastroenterol Res Pract. 2011: 917941. doi:10.1155/2011/917941. PMC 3226317. PMID 22144997.
- ↑ Kountouras J, Zavos C (2008). "Recent advances in the management of radiation colitis". World J Gastroenterol. 14 (48): 7289–301. PMC 2778112. PMID 19109862.
- ↑ Shih HY, Wu DC, Huang WT, Chang YY, Yu FJ (2011). "Glutaraldehyde-induced colitis: case reports and literature review". Kaohsiung J Med Sci. 27 (12): 577–80. doi:10.1016/j.kjms.2011.06.036. PMID 22208542 PMID: 22208542 Check
|pmid=value (help). - ↑ Abhishek K, Kaushik S, Kazemi MM, El-Dika S (2008). "An unusual case of hematochezia: acute ischemic proctosigmoiditis". J Gen Intern Med. 23 (9): 1525–7. doi:10.1007/s11606-008-0673-2. PMC 2518031. PMID 18521689.