Proctitis

Common causes include ulcerative colitis or Crohn's disease; infections, including sexually transmitted infections (such as gonorrhoea, chlamydia, herpes and syphilis), and bowel infections; radiation to the pelvis; reduced blood supply to the rectum, especially in older people; allergic proctitis in babies; and some medicines or enemas. Straining and long-term constipation can irritate the rectum too. In all cases a doctor must find out which of these applies.

Proctitis is fairly common. Ulcerative colitis, an inflammatory bowel disease, commonly begins in the rectum, and infections are an important cause in people who have anal sex. Radiation proctitis can follow radiotherapy to the pelvis, such as for prostate, cervical or other cancers.

The doctor asks about your symptoms, sexual history, past treatments such as radiotherapy, and medicines, and examines the anus and rectum. A look inside with a flexible sigmoidoscopy or colonoscopy usually shows the inflamed lining, and biopsies are taken. Stool tests and swabs look for infection, and blood tests may check for inflammation or anaemia. Questions about sexual practices are asked only to find the right test and are kept confidential. The doctor decides which tests you need.

Treat the cause first. These steps support comfort and recovery.

• See a doctor for any rectal bleeding or ongoing rectal symptoms

• Do not use enemas, creams or leftover medicines without advice

• Warm sitz baths and gentle cleaning with water can soothe soreness

• If an infection is found, complete treatment and avoid sex until your doctor says it is safe; partners may need testing

• Do not smoke; it can worsen some bowel conditions

Diet does not cure proctitis but can ease symptoms while it heals.

• Drink plenty of fluids, especially with diarrhoea

• Eat small, regular meals; avoid foods you notice make symptoms worse

• Keep stools soft and easy to pass with enough fibre if constipated

• For babies, never change feeds or give home remedies without a doctor's advice

Medicines depend on the cause; your doctor chooses and prescribes them.

• For ulcerative proctitis: anti-inflammatory suppositories or enemas, and sometimes tablets or other bowel-disease medicines

• For infection: the right antibiotic or antiviral medicine for the organism found

• For radiation proctitis: anti-inflammatory treatments and treatment of bleeding or anaemia

• Stool softeners if straining is part of the problem

• Take medicines exactly as prescribed even when symptoms settle, unless your doctor says otherwise

Procedures are needed only for particular causes or when medicines are not enough.

• Sigmoidoscopy or colonoscopy to confirm the diagnosis and take biopsies

• Endoscopic treatment of bleeding blood vessels in radiation proctitis, such as argon plasma coagulation

• Treatment of complications such as narrowing (stricture) or fistula, if they occur

• Surgery is rarely needed and is reserved for severe or complicated cases

The outlook depends on the cause. Infectious proctitis usually clears with the right treatment. Proctitis from ulcerative colitis often responds well to treatment but can recur and needs long-term follow-up. Radiation proctitis may settle gradually, though some people have symptoms for a long time and need specialist care.

• What is causing my proctitis?

• Do I need a scope examination or other tests?

• Which treatment do you recommend and for how long?

• Could this be ulcerative colitis, and will it spread higher up the bowel?

• Does my partner need testing or treatment?

This guide comes from the Saudi Gastroenterology Association (SGA) patient library, prepared by the Approved for publication by SGA; individual clinician review is ongoing. Last reviewed: 2026-04-24. It is for education and does not replace your doctor's advice.