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Clin Colon Rectal Surg 2004; 17(1): 21-27
DOI: 10.1055/s-2004-823067
Copyright © 2004 by Thieme Medical Publishers, Inc., 333 Seventh Avenue, New York, NY 10001, USA.

Ulcerative Proctitis

Charles B. Whitlow1
  • 1Department of Colon and Rectal Surgery, Ochsner Clinic Foundation, New Orleans, Louisiana
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Publication History

Publication Date:
13 April 2004 (online)

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Ulcerative proctitis is an idiopathic mucosal inflammatory disease involving only the rectum and is therefore an anatomically limited form of ulcerative colitis. Diagnosis is made based on clinical presentation, endoscopic appearance, and histopathology. Additionally, other etiologies of proctitis are excluded. The course of the disease is variable ranging from complete resolution to easily maintained remission to frequent relapses or refractory disease. Extension of inflammatory changes involving the proximal colon occurs in some cases. Rectal 5-aminosalicylic acid (5-ASA) or steroids are the initial treatments of choice with oral 5-ASA, sulfasalazine, or steroids used for treatment failures or patients unable to tolerate rectally administered drugs. Immunomodulators like azathioprine and 6-mercaptopurine have been used successfully in small groups of patients who have not responded to 5-ASA or steroids. Oral or rectal 5-ASA products maintain remission but long-term steroid use should be avoided. Rare cases may require surgical therapy.

KEYWORDS

Proctitis - ulcerative proctitis - 5-ASA - hydrocortisone

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Charles B WhitlowM.D. 

Department of Colon and Rectal Surgery, Ochsner Clinic Foundation

1514 Jefferson Hwy.

New Orleans, LA 70121

Email: cwhitlow@ochsner.org

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