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Proctitis: An Approach to the Symptomatic Patient.

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Proctitis, an inflammation of the rectum, is often linked to sexually transmitted infections (STIs). Early diagnosis through history, examination, and STI testing is crucial for effective treatment.

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Area of Science:

  • Infectious Diseases
  • Gastroenterology
  • Sexual Health

Background:

  • Proctitis is an inflammatory condition affecting the distal rectum.
  • It is frequently associated with common sexually transmitted infections (STIs).

Purpose of the Study:

  • To outline the differential diagnoses for proctitis, particularly in cases with ulcerative findings.
  • To highlight the importance of considering emerging pathogens and diagnostic approaches for proctitis.

Main Methods:

  • Review of common and emerging causes of proctitis.
  • Emphasis on clinical evaluation including anoscopy.
  • Recommendation for rectal nucleic acid amplification STI testing.

Main Results:

  • Common STIs like gonorrhea, chlamydia, and syphilis are frequent causes.
  • Ulcerative proctitis may involve Mpox, lymphogranuloma venereum, and herpes simplex virus.
  • Mycoplasma genitalium is an emerging pathogen implicated in proctitis.

Conclusions:

  • A thorough patient history and clinical assessment are vital.
  • Anoscopy and rectal STI testing aid in accurate diagnosis.
  • Identifying the specific cause allows for targeted and effective treatment of proctitis.