Proctitis: An Approach to the Symptomatic Patient.

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.