Ulcerative proctitis is an inflammation and ulceration of the rectal lining.
Symptoms vary between people.
Treatment involves both reducing symptoms and addressing the underlying inflammation causing symptoms.
Verywell / Jessica Olah
In remission, mesalamine suppositories are used.
Anti-Inflammatory Medication
Treatment using medication varies based on the level of inflammation.
Mild inflammation may require enemas, foam, or suppositories.
More severe inflammation may require oral medication.
Medication choices also depend on if treatment is for symptom relief or treating underlying inflammation.
5-Aminosalicylic acid (5-ASA)assists in reducing acute inflammation.
If taken at a maintenance dose long term, it can help deter inflammation.
Some 5-ASAs can be taken orally.
These include:
5-ASAs can also be taken via the rectum.
This can often bring about faster results.
Suppositories of 5-ASAs include:
In some cases, 5-ASAs may be given as an enema.
Once inflammation improves, this may be followed by a suppository.
Corticosteroidsare used to treat inflammation and are taken rectally.
This treatment is available as a suppository, foam, or liquid preparation.
Biological therapies using immunotherapy help the body’s immune system and stopping proteins from causing inflammation.
They are often used as a form of cancer treatment.
Medications in this category include:
Will I need surgery for ulcerative proctitis?
The cause of ulcerative proctitis is unknown.
However, some people with the condition notice that stress and being busy may aggravate symptoms causing a flare.
Living With Ulcerative Proctitis
Many people with ulcerative proctitis lead normal active lives.
Symptoms may vary from person to person.
Stress and tension can make symptoms of ulcerative proctitis worse.
Decreasing stress and practicing relaxation techniques may help.
Those living with ulcerative proctitis may find it helpful to talk to others experiencing the same symptoms.
Does ulcerative proctitis go away?
Complications
If left untreated, ulcerative proctitis can lead to a number of complications.
These include:
If I have ulcerative proctitis, will I develop ulcerative colitis?
The chance of ulcerative proctitis spreading to the colon to develop into ulcerative colitis is small.
Only 10% to 30% of people with ulcerative proctitis have inflammation spread beyond the rectum.
Less than 15% of those with ulcerative proctitis go on to develop chronic ulcerative colitis.
Summary
Ulcerative proctitis involves inflammation of the rectum.
Symptoms can include diarrhea, fecal incontinence, and rectal pain.
This disease differs from ulcerative colitis, which impacts the entire colon.
Gecse KB, Lakatos PL.Ulcerative proctitis: an update on the pharmacotherapy and management.Expert Opin Pharmacother.
2014;15(11):1565-1573. doi:10.1517/14656566.2014.920322
GI Society/Canadian Society of Intestinal Research.Ulcerative proctitis.
https://doi.org/10.1038/s41598-022-25218-x
American Cancer Society.Understanding Biologic and Biosimilar Drugs.
2023 Apr 15;15(4):e37609.
PMID: 37069838; PMCID: PMC10105519.
Crohn’s and Colitis Foundation.Surgery for Ulcerative Colitis
Colon and Rectal Surgery Associates.Ulcerative proctitis.
National Institute of Diabetes and Digestive and Kidney Diseases.Definition & facts for proctitis.
National Organization for Rare Disorders.Proctitis.
