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| __NOTOC__
| | #REDIRECT:[[Colitis]] |
| {{SI}}
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| {{CMG}}; {{AE}} {{QS}}
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| ==Overview==
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| '''Proctocolitis''' is a general term for [[inflammation]] of the [[rectum]] and [[Colon (anatomy)|colon]] particularly distal part of the colon([[sigmoid]])<ref>Online Medical dictionary[http://cancerweb.ncl.ac.uk/cgi-bin/omd?proctocolitis]</ref>. Common causes of proctocolitis include ''[[Chlamydia trachomatis]]'', ''[[Lymphogranuloma Venereum]]'', ''[[Neisseria gonorrhoeae]]'', [[Herpes Simplex Virus|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.
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| ==Historical Perspective==
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| ==Classification==
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| There is no established classification system for proctocolitis. However, it may be classified based on etiology, age and duration of symptom.
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| ===Classification by etiology===
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| *[[Infectious]]
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| **Viral
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| **Bacterial
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| **Fungal,
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| **Protozoan
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| **Atypical micro-organism.
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| *[[Allergic (eosinophilic)]]
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| *[[Vascular]]
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| *[[Autoimmune]]
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| *[[Drug-induced]]
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| *[[Radiation]]
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| *[[Chemical]]
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| *[[Idiopathic]]
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| ===Classification by Age===
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| * '''Infantile''': Usually presents in early infancy.<ref name="pmid25976434">{{cite journal| author=Nowak-Węgrzyn A| title=Food protein-induced enterocolitis syndrome and allergic proctocolitis. | journal=Allergy Asthma Proc | year= 2015 | volume= 36 | issue= 3 | pages= 172-84 | pmid=25976434 | doi=10.2500/aap.2015.36.3811 | pmc=4405595 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=25976434 }} </ref><ref name="pmid11264489">{{cite journal| author=Pumberger W, Pomberger G, Geissler W| title=Proctocolitis in breast fed infants: a contribution to differential diagnosis of haematochezia in early childhood. | journal=Postgrad Med J | year= 2001 | volume= 77 | issue= 906 | pages= 252-4 | pmid=11264489 | doi= | pmc=1741985 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=11264489 }} </ref><ref name="pmid21922029">{{cite journal| author=Alfadda AA, Storr MA, Shaffer EA| title=Eosinophilic colitis: epidemiology, clinical features, and current management. | journal=Therap Adv Gastroenterol | year= 2011 | volume= 4 | issue= 5 | pages= 301-9 | pmid=21922029 | doi=10.1177/1756283X10392443 | pmc=3165205 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=21922029 }} </ref>
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| * '''Adults'''
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| ===Classification by duration of symptoms===
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| *Acute: for example allergic proctocolitis in infants.
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| *Chronic: Usually months to years, for example ulcerative colitis.
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| ==Pathophysiology==
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| The exact pathophysiology of proctolcolitis is not fully understood. However, several mechanisms are hypothesized to play a role in the pathogenesis.<ref name="pmid25976434">{{cite journal| author=Nowak-Węgrzyn A| title=Food protein-induced enterocolitis syndrome and allergic proctocolitis. | journal=Allergy Asthma Proc | year= 2015 | volume= 36 | issue= 3 | pages= 172-84 | pmid=25976434 | doi=10.2500/aap.2015.36.3811 | pmc=4405595 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=25976434 }} </ref><ref name="pmid11264489">{{cite journal| author=Pumberger W, Pomberger G, Geissler W| title=Proctocolitis in breast fed infants: a contribution to differential diagnosis of haematochezia in early childhood. | journal=Postgrad Med J | year= 2001 | volume= 77 | issue= 906 | pages= 252-4 | pmid=11264489 | doi= | pmc=1741985 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=11264489 }} </ref><ref name="pmid21922029">{{cite journal| author=Alfadda AA, Storr MA, Shaffer EA| title=Eosinophilic colitis: epidemiology, clinical features, and current management. | journal=Therap Adv Gastroenterol | year= 2011 | volume= 4 | issue= 5 | pages= 301-9 | pmid=21922029 | doi=10.1177/1756283X10392443 | pmc=3165205 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=21922029 }} </ref><ref name="pmid22144997">{{cite journal| author=Do NL, Nagle D, Poylin VY| title=Radiation proctitis: current strategies in management. | journal=Gastroenterol Res Pract | year= 2011 | volume= 2011 | issue= | pages= 917941 | pmid=22144997 | doi=10.1155/2011/917941 | pmc=3226317 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=22144997 }} </ref><ref name="pmid19109862">{{cite journal| author=Kountouras J, Zavos C| title=Recent advances in the management of radiation colitis. | journal=World J Gastroenterol | year= 2008 | volume= 14 | issue= 48 | pages= 7289-301 | pmid=19109862 | doi= | pmc=2778112 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=19109862 }} </ref><ref name="pmidPMID: 22208542">{{cite journal| author=Shih HY, Wu DC, Huang WT, Chang YY, Yu FJ| title=Glutaraldehyde-induced colitis: case reports and literature review. | journal=Kaohsiung J Med Sci | year= 2011 | volume= 27 | issue= 12 | pages= 577-80 | pmid=PMID: 22208542 | doi=10.1016/j.kjms.2011.06.036 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=22208542 }} </ref><ref name="pmid18521689">{{cite journal| author=Abhishek K, Kaushik S, Kazemi MM, El-Dika S| title=An unusual case of hematochezia: acute ischemic proctosigmoiditis. | journal=J Gen Intern Med | year= 2008 | volume= 23 | issue= 9 | pages= 1525-7 | pmid=18521689 | doi=10.1007/s11606-008-0673-2 | pmc=2518031 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=18521689 }} </ref>
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| ==Causes==
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| Proctocolitis has many possible causes. Common infectious causes of proctocolitis include ''[[Chlamydia trachomatis]]'', [[Lymphogranuloma Venereum|LGV (Lymphogranuloma Venereum)]], ''[[Neisseria gonorrhoeae]]'', [[Herpes Simplex Virus|HSV]], and [[Campylobacter|Campylobacter species]]. It can also be idiopathic (see [[colitis]]), vascular (as in [[ischemic colitis]]), or autoimmune (as in [[inflammatory bowel disease]]).
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| ===Life Threatening Causes===
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| ===Common Causes===
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| ===Causes by Organ System===
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| {|style="width:80%; height:100px" border="1"
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| |style="height:100px"; style="width:25%" border="1" bgcolor="LightSteelBlue" |'''Cardiovascular'''
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| |style="height:100px"; style="width:75%" border="1" bgcolor="Beige" | No underlying causes
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| |-
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| |bgcolor="LightSteelBlue"| '''Chemical/Poisoning'''
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| |bgcolor="Beige"| No underlying causes
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| |-
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| |-bgcolor="LightSteelBlue"
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| | '''Dental'''
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| |bgcolor="Beige"| No underlying causes
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| |-
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| |-bgcolor="LightSteelBlue"
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| | '''Dermatologic'''
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| |bgcolor="Beige"| No underlying causes
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| |-
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| |-bgcolor="LightSteelBlue"
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| | '''Drug Side Effect'''
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| |bgcolor="Beige"| [[Chlorpropamide]]
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| |-
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| |-bgcolor="LightSteelBlue"
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| | '''Ear Nose Throat'''
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| |bgcolor="Beige"| No underlying causes
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| |-
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| |-bgcolor="LightSteelBlue"
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| | '''Endocrine'''
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| |bgcolor="Beige"| No underlying causes
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| |-
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| |-bgcolor="LightSteelBlue"
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| | '''Environmental'''
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| |bgcolor="Beige"| No underlying causes
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| |-
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| |-bgcolor="LightSteelBlue"
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| | '''Gastroenterologic'''
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| |bgcolor="Beige"| No underlying causes
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| |-
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| |-bgcolor="LightSteelBlue"
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| | '''Genetic'''
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| |bgcolor="Beige"| No underlying causes
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| |-
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| |-bgcolor="LightSteelBlue"
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| | '''Hematologic'''
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| |bgcolor="Beige"| No underlying causes
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| |-
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| |-bgcolor="LightSteelBlue"
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| | '''Iatrogenic'''
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| |bgcolor="Beige"| No underlying causes
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| |-
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| |-bgcolor="LightSteelBlue"
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| | '''Infectious Disease'''
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| |bgcolor="Beige"| No underlying causes
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| |-
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| |-bgcolor="LightSteelBlue"
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| | '''Musculoskeletal/Orthopedic'''
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| |bgcolor="Beige"| No underlying causes
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| |-
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| |-bgcolor="LightSteelBlue"
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| | '''Neurologic'''
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| |bgcolor="Beige"| No underlying causes
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| |-
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| |-bgcolor="LightSteelBlue"
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| | '''Nutritional/Metabolic'''
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| |bgcolor="Beige"| No underlying causes
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| |-
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| |-bgcolor="LightSteelBlue"
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| | '''Obstetric/Gynecologic'''
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| |bgcolor="Beige"| No underlying causes
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| |-
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| |-bgcolor="LightSteelBlue"
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| | '''Oncologic'''
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| |bgcolor="Beige"| No underlying causes
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| |-
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| |-bgcolor="LightSteelBlue"
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| | '''Ophthalmologic'''
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| |bgcolor="Beige"| No underlying causes
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| |-
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| |-bgcolor="LightSteelBlue"
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| | '''Overdose/Toxicity'''
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| |bgcolor="Beige"| No underlying causes
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| |-
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| |-bgcolor="LightSteelBlue"
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| | '''Psychiatric'''
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| |bgcolor="Beige"| No underlying causes
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| |-
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| |-bgcolor="LightSteelBlue"
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| | '''Pulmonary'''
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| |bgcolor="Beige"| No underlying causes
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| |-
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| |-bgcolor="LightSteelBlue"
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| | '''Renal/Electrolyte'''
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| |bgcolor="Beige"| No underlying causes
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| |-
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| |-bgcolor="LightSteelBlue"
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| | '''Rheumatology/Immunology/Allergy'''
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| |bgcolor="Beige"| No underlying causes
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| |-
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| |-bgcolor="LightSteelBlue"
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| | '''Sexual'''
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| |bgcolor="Beige"| No underlying causes
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| |-
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| |-bgcolor="LightSteelBlue"
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| | '''Trauma'''
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| |bgcolor="Beige"| No underlying causes
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| |-
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| |-bgcolor="LightSteelBlue"
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| | '''Urologic'''
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| |bgcolor="Beige"| No underlying causes
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| |-
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| |-bgcolor="LightSteelBlue"
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| | '''Miscellaneous'''
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| |bgcolor="Beige"| No underlying causes
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| |-
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| |}
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| ===Causes in Alphabetical Order===
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| {{col-begin|width=80%}}
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| {{col-break|width=33%}}
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| * [[Chlorpropamide]]
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| {{col-break|width=33%}}
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| * Disease B
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| {{col-break|width=33%}}
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| * Disease C
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| {{col-end}}
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| ==Differentiating {{PAGENAME}} from Other Diseases==
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| ==Epidemiology and Demographics==
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| ==Risk Factors==
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| ==Screening==
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| ==Natural History, Complications, and Prognosis==
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| ===Natural History===
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| ===Complications===
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| ===Prognosis===
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| ==Diagnosis==
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| ===Diagnostic Criteria===
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| ===History and Symptoms===
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| ===Physical Examination===
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| ===Laboratory Findings===
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| ===Imaging Findings===
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| ===Other Diagnostic Studies===
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| ==Treatment==
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| ===Medical Therapy===
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| *All patients with proctocolitis should be treated.
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| *Treatment of proctocolitis is similar to that of proctitis.
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| *Generally, the following regimen is recommended:
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| :: Preferred regimen: [[Ceftriaxone]] 250 mg IM {{and}} [[Doxycycline]] 100 mg PO bid for 7 days
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| To view additional treatment and special considerations for the management of proctitis/proctocolitis, click [[proctitis medical therapy|'''here''']].
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| ===Surgery===
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| ===Prevention===
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| ==See also==
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| * [[Colitis]]
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| * [[Proctitis]]
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| ==References==
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| {{reflist|2}}
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| [[Category:Gastroenterology]]
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