Proctocolitis
|
WikiDoc Resources for Proctocolitis |
|
Articles |
|---|
|
Most recent articles on Proctocolitis Most cited articles on Proctocolitis |
|
Media |
|
Powerpoint slides on Proctocolitis |
|
Evidence Based Medicine |
|
Clinical Trials |
|
Ongoing Trials on Proctocolitis at Clinical Trials.gov Trial results on Proctocolitis Clinical Trials on Proctocolitis at Google
|
|
Guidelines / Policies / Govt |
|
US National Guidelines Clearinghouse on Proctocolitis NICE Guidance on Proctocolitis
|
|
Books |
|
News |
|
Commentary |
|
Definitions |
|
Patient Resources / Community |
|
Patient resources on Proctocolitis Discussion groups on Proctocolitis Patient Handouts on Proctocolitis Directions to Hospitals Treating Proctocolitis Risk calculators and risk factors for Proctocolitis
|
|
Healthcare Provider Resources |
|
Causes & Risk Factors for Proctocolitis |
|
Continuing Medical Education (CME) |
|
International |
|
|
|
Business |
|
Experimental / Informatics |
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 proctocolitis is not fully understood. However, several mechanisms are hypothesized to play a role in the pathogenesis.
Pathogenesis
Pathogenesis of Allergic proctocolitis
- It is a non IgE, T cell mediated immunological reaction against food protein antigens with Eosinophil accumulation in intestinal tract and subsequent inflammation.[3][5][6]
- Could be an autoimmune disease. Atypical p antineutrophil cytoplasmic antibodies (a-pANCA) have been seen in some infants with intestinal infiltration by Neutrophils.[7]
Pathogenesis of Infectious proctocolitis
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
|
|
|
|
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]
- ↑ 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.
- ↑ 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.
- ↑ Lucarelli S, Di Nardo G, Lastrucci G, D'Alfonso Y, Marcheggiano A, Federici T; et al. (2011). "Allergic proctocolitis refractory to maternal hypoallergenic diet in exclusively breast-fed infants: a clinical observation". BMC Gastroenterol. 11: 82. doi:10.1186/1471-230X-11-82. PMC 3224143. PMID 21762530.
- ↑ Chesworth BM, Hamilton CB, Walton DM, Benoit M, Blake TA, Bredy H; et al. (2014). "Reliability and validity of two versions of the upper extremity functional index". Physiother Can. 66 (3): 243–53. doi:10.3138/ptc.2013-45. PMC 4130402. PMID 25125777.
- ↑ Sekerkova A, Fuchs M, Cecrdlova E, Svachova V, Kralova Lesna I, Striz I; et al. (2015). "High Prevalence of Neutrophil Cytoplasmic Autoantibodies in Infants with Food Protein-Induced Proctitis/Proctocolitis: Autoimmunity Involvement?". J Immunol Res. 2015: 902863. doi:10.1155/2015/902863. PMC 4592904. PMID 26484355.