Proctocolitis
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [2]; Associate Editor(s)-in-Chief:
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.
Historical Perspective
Classification
There is no established classification system for proctocolitis. However, proctocolitis may be classified based on causality into
- Infectious
- Non-infectious
- Infectious proctocolitis may be viral, bacterial, fungal, protozoan, and atypical micro-organism.
- Non-infectious proctocolitis may be allergic (eosinophilic), vascular, autoimmune, drug-induced, radiation, chemical, and idiopathic.
Pathophysiology
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.