Treating Ulcerative Proctitis

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Ulcerative proctitis is an inflammation and ulceration of the rectal lining. In ulcerative proctitis, sores and ulcers form in the inner lining of the rectum, the lowest part of the large intestine. This can cause uncomfortable symptoms like diarrhea, bleeding, rectal pain, and fecal incontinence.

Symptoms vary between people. Some will experience constant symptoms of ulcerative proctitis, while others will be symptom-free for months and then suddenly experience flare-ups.

This article will discuss how ulcerative proctitis is treated, how you can cope with the condition, and possible complications.

Person heading into restroom due to diarrhea and pain

Ratree Khotchalee / Getty Images

Treatment

Treatment options for ulcerative proctitis vary based on the severity of the condition. Treatment involves both reducing symptoms and addressing the underlying inflammation causing symptoms.

Standard Treatment

U.S. and European clinical guidelines recommend oral salicylates, topical mesalamine, or topical steroids for mild to moderate ulcerative proctitis (distal colitis). In remission, mesalamine suppositories are used.

Medication

Treatment using medication varies based on the level of inflammation. Mild inflammation may require enemas, foam, or suppositories. More severe inflammation may require oral medication. Medication choices also depend on if treatment is for symptom relief or treating underlying inflammation.

Symptom Relief

Anti-diarrheal medications may be prescribed to help control bowel movements and stop cramping.

Medications in this category include:

Anti-Inflammatory Therapy

Medicines that reduce inflammation may be prescribed and can be taken orally or topically as suppositories, enemas, and foam.

5-Aminosalicylic acid (5-ASA) assists in reducing acute inflammation. If taken at a maintenance dose long term, it can help deter inflammation.

Some 5-ASAs can be taken orally. These include:

  • Mesasal (mesalazine)
  • Asacol (mesalamine)
  • Mezavant (mesalamine)
  • Pentasa (mesalamine)
  • Salofalk (mesalamine)
  • Dipentum (olsalazine sodium)

5-ASAs can also be taken via the rectum. This can often bring about faster results. Suppositories of 5-ASAs include:

  • Salofalk (mesalamine): 500 mg and 1 g suppositories
  • Pentasa (mesalamine): 1 g suppositories

In some cases, 5-ASAs may be given as an enema. Once inflammation improves, this may be followed by a suppository.

Corticosteroids are used to treat inflammation and are taken rectally. This treatment is available as a suppository, foam, or liquid preparation.

These medications include:

Diet

Diet modifications can assist in reducing symptoms of ulcerative proctitis:

  • A high-fiber diet either through eating high-fiber foods or by taking a fiber supplement may assist symptoms.
  • Avoiding dairy products may help some people with uncomfortable symptoms like diarrhea, bloating, cramps, and gas. Swapping dairy items to lactose-free alternatives like lactose-free milk, yogurt, and ice cream may help.
  • Avoiding raw fruits and vegetables as well as spicy foods may help when having diarrhea.

Living With Ulcerative Proctitis

Many people with ulcerative proctitis lead normal active lives. Symptoms may vary from person to person. Whether symptoms are constant or present only during a flare-up, regular appointments with a physician are necessary to monitor the disease and adjust medications where necessary.

Stress and tension can make symptoms of ulcerative proctitis worse. Decreasing stress and practicing relaxation techniques may help.

Those living with ulcerative proctitis may find it helpful to talk to others experiencing the same symptoms. Support groups are a good place to start. The Crohn’s and Colitis Foundation has a register of over 200 support groups across the United States.

Complications

If left untreated, ulcerative proctitis can lead to a number of complications. These include:

Summary

Ulcerative proctitis involves inflammation of the rectum. Symptoms can include diarrhea, fecal incontinence, and rectal pain. This disease differs from ulcerative colitis, which impacts the entire colon. There is no cure for ulcerative proctitis, but treatment options are available to relieve symptoms and address underlying inflammation.

A Word From Verywell

Living with a chronic condition such as ulcerative proctitis is challenging. You may not want to discuss the symptoms with others, yet you also need those around you to understand what you are experiencing.

Maintaining communication with your healthcare professional to address the symptoms and prevent flare-ups can help your quality of life.

Frequently Asked Questions

  • What is the difference between ulcerative colitis and ulcerative proctitis?

    Ulcerative proctitis involves inflammation that is limited only to the rectum. Ulcerative colitis impacts the entire colon.

  • What causes an ulcerative proctitis flare-up?

    The cause of ulcerative proctitis is unknown. However, some people with the condition notice that stress and being busy may aggravate symptoms causing a flare.

  • Is there a cure for ulcerative proctitis?

    There is no cure for ulcerative proctitis. However, there are a number of treatments that can ease severity of symptoms and help induce remission.

  • If I have ulcerative proctitis, will I develop ulcerative colitis?

    The chance of ulcerative proctitis spreading to the colon to develop into ulcerative colitis is small. Only 10% to 30% of people with ulcerative proctitis have inflammation spread beyond the rectum. Less than 15% of those with ulcerative proctitis go on to develop chronic ulcerative colitis.

 

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7 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
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