Proctitis
Introduction
Introduction to proctitis The proctitis is mild and only the mucous membrane is inflamed. In severe cases, the inflammation involves the submucosa, the muscular layer, and even the tissues around the rectum. Sometimes only a part of the rectal mucosa is involved, and sometimes the rectal mucosa is inflamed, and the mucosa of the colon may also be involved in inflammation. Proctitis is common in low body weakness, heart, lung, liver, gastrointestinal diseases, respiratory infections, infectious diseases, constipation, diarrhea, convulsions, anorectal prolapse, anal fistula, polyposis, anorectal stenosis , rectal tumors, rectal injuries, foreign bodies, etc., can make the rectum inflamed, serious need to go to the hospital for surgery. The most common cause is foreign body damage in the rectum. Undigested bone fragments, wood chips or other foreign objects with sharp angles can directly damage the rectal mucosa and cause proctitis. In addition, a hard stool block in the event of severe constipation can cause proctitis. basic knowledge The proportion of illness: 0.3% Susceptible people: no specific population Mode of infection: non-infectious Complications: anal sinusitis anal canal, rectum, colon stenosis iron deficiency anemia
Cause
Cause of proctitis
Foreign body damage (15%):
The most common cause is foreign body damage in the rectum. Undigested bone fragments, wood chips or other foreign objects with sharp angles can directly damage the rectal mucosa and cause proctitis. In addition, a hard stool block in the event of severe constipation can cause proctitis.
Poisoning and infection (10%):
When a rodenticide or a heavy metal (mercury, arsenic, etc.) is poisoned or an infectious disease characterized by gastroenteritis occurs, proctitis is often followed. However, at this time, the pathological changes of other gastrointestinal tubes are more serious than those of the rectum, and in most cases, clinical symptoms are manifested by this disease.
Benign tumor malignant (8%):
This disease is also one of the causes of proctitis. Generally, rectal familial polyposis, rectal adenoma, papilloma, etc., under certain conditions, can also lead to malignant lesions.
Dietary factors (10%):
A high-fat, high-protein, low-fiber diet is associated with the pathogenesis of proctitis. This is because high-fat foods can increase bile secretion and promote intestinal bacterial growth, while cholesterol and bile salts form unsaturated cholesterol, such as deoxycholic acid and lithocholic acid, under the action of anaerobic bacteria. The increase in the number of drugs promotes the onset of proctitis.
Chronic inflammatory irritation (12%):
Chronic chronic inflammation may be an essential cause of anorectal inflammation. Such as chronic bacterial infection, amoebic dysentery, chronic non-specific colitis, diverticulitis, etc., causing granuloma, inflammatory changes and pseudopolyps to undergo inflammation.
Benign tumor malignancy (3%):
Rectal familial polyposis, rectal adenoma, papilloma, etc., under certain conditions, can also lead to malignant lesions.
Due to sexually transmitted diseases (8%):
Unclean sexual intercourse, the anus is suffering from condyloma acuminata or papillary fibroids, long-term friction stimulation, can cause inflammation.
Family genetic factors (4%):
The transmission of genetic alterations can be manifested in familiality.
Abnormal immune function (12%):
Abnormal human immune function, such as cellular immune function inhibition is prevalent in patients, with the decrease of cellular immune reactivity, the incidence of inflammation is increased, and inhibition of cellular immune function is a major factor in the development of inflammation.
Acne, anal fistula, anal fissure, suppurative sweat gland inflammation, folliculitis and other long-term stimulation of anal skin can also cause inflammation.
The large intestinal mucosa of schistosomiasis patients is stimulated by the sedimentary eggs for a long time, causing necrosis, shedding, and even ulceration, and then polyps occur on the basis of epithelial regeneration and proliferation, leading to inflammation.
Prevention
Proctitis prevention
1. Preventive measures: Avoiding anal sex can prevent proctitis from spreading through sexual intercourse and reduce intake of caffeine, dairy foods and high-fat foods. Artificial sweeteners can reduce the incidence of proctitis. Studies have shown that there is a link between large intestine ulcers and regular consumption of foods; various methods of decompression, such as yoga, tai chi and deep relaxation, can also reduce the risk of rectal inflammation. Studies have shown that in the case of heavy pressure, it can cause inflammation of the intestinal wall and may cause inflammatory bowel disease.
2, prevention of complications: complications of proctitis can be caused by the formation of ulcers and cause severe bleeding. Proctitis caused by large intestine ulcers has the potential to develop into a wider range of ulcers in the colon and other parts of the gastrointestinal tract.
Complication
Proctitis complications Complications Anal sinusitis Anal canal, rectum, colon stenosis Iron deficiency anemia
Anal sinusitis
Proctitis may cause anorectal diseases such as anal sinusitis when there is no timely treatment, and there is a risk of secondary perianal abscess.
Stenosis
Many patients with symptoms lasting for more than 5-25 years, generally asymptomatic signs, can cause intestinal obstruction in severe cases, in the case of intestinal stenosis, should be alert to the tumor, timely identification of benign malignant, in order to symptomatic treatment.
Intestinal polyps, colonic malignant transformation
Proctitis for more than five years, the intestinal ulcer surface will be prone to abnormal hyperplasia under the long-term stimulation of inflammation, causing intestinal polyps, the malignant rate of intestinal polyps more than one centimeter is extremely high.
Anal canal
This is the most common disease associated with proctitis, often associated with proctitis and called anorectal inflammation, anal canal inflammation and long-term risk of malignant transformation.
Iron deficiency anemia
Blood in the stool is one of the main clinical manifestations of this disease. The amount of blood in the stool is also an indicator to measure the severity of the disease. Long-term chronic bleeding can cause iron deficiency anemia.
Symptom
Symptoms of rectal inflammation Common symptoms in acute post-abdominal pain, rectal pain, old fecal incontinence, constipation, diarrhea and constipation, alternating feces, pus, rectal anus, internal pain, discomfort, diarrhea
Symptoms of proctitis include diarrhea, abdominal pain, and bloating. Constipation and diarrhea alternate, and it contains mucus and blood. Proctitis can also cause strong anal pain, so when anal pain occurs, it should be carefully diagnosed, and the cause can be found through electronic anorectal surgery.
1. Acute proctitis: systemic symptoms of acute proctitis have fever and loss of appetite. Local symptoms mainly manifested as anal internal burning heat burning, frequent intentions, mixed mucus and blood in the stool, heavy and urgency, poor urination, frequent urination.
2. Chronic proctitis: constipation and diarrhea alternate, it contains mucus and bloodshot, burning pain in the anus. Due to the secretion of secretions, the epidermis around the anus is detached, sometimes itching into the mouth, the lower abdomen is full of discomfort, loss of appetite, weight loss, general malaise.
3. Radioactive proctitis: rectal bleeding, bright red or dark red, mostly in the defecation, usually a small amount of bleeding, occasionally a large number of bleeding. After the rupture, there is necrotic tissue exfoliation, odor, soreness or burning pain in the anorectal, and later spurs due to stimulation of the sphincter.
4. Tuberculous proctitis: patients feel discomfort in the rectum, sometimes constipation, diarrhea alternate, with the symptoms of the disease mostly diarrhea, feces are sparse water, mixed with pus, smelly, urgency, lower abdominal pain, bloating, Loss of appetite and weight loss.
Examine
Proctitis examination
(1) refers to the diagnosis : the rectal mucosa can be weakened, and the granules are rough or scarred. Rectal examination showed mucosal edema, hypertrophy, yellowish white, covered mucus, wiped off mucus, visible mucosal surface is not smooth, and some parts have erosion. Bacterial culture and biopsy can determine the cause of the disease.
(B) electronic anorectal examination : electronic anorectal surgery using medical video and camera technology, both doctors and patients can clearly observe the lesions magnified dozens of times at the same time. Help patients understand the treatment options to avoid delays caused by traditional human examinations. At the same time, the lesion can be locked and printed and imaged, which provides a reliable basis for comparison before and after treatment. The mucous membrane is swollen and hypertrophy. The surface is rough and has a small amount of mucus. The atrophic proctitis can be seen under the microscope: the mucous membrane is dry, the color is gray, and the vascular network is visible under the mucosa.
Diagnosis
Diagnosis and proctification of proctitis
Diagnosis of proctitis:
Chronic proctitis can be touched by the rectal mucosa with reduced elasticity, coarse granules or scars. Rectal examination showed mucosal edema, hypertrophy, yellowish white, covered mucus, wiped off mucus, visible mucosal surface is not smooth, and some parts have erosion. Bacterial culture and biopsy can determine the cause of the disease. The characteristics of chronic proctitis microscopy are: swelling of the mucous membrane, hypertrophy, rough surface of the mucous membrane, a small amount of mucus, atrophic proctitis visible under the microscope: dry mucosa, grayish white, visible vascular network under the mucosa.
Acute proctitis anal swelling and fever, the skin of the anus is damp and red, and the rectum touches the rectum with severe pain. The sphincter is anal fistula. Rectal examination revealed mucosal congestion, edema, hemorrhage, erosion, yellow pus or spotted ulcer on the surface, stool culture or biopsy to find pathogenic bacteria, to determine the cause of the diagnosis. The characteristics of acute proctitis microscopy are: the rectal mucosa is dark red, swollen, with longitudinal wrinkles, and there are secretions between the wrinkles.
Diagnosis of ulcerative proctitis: If the condition becomes mild, only intermittent small amount of rectal bleeding may be mistaken for hemorrhoids. Some patients also show constipation, mostly due to inflammation of the rectal fistula. Some patients have ulcerative proctitis, but they do not have the symptoms of blood in the stool, but only the number of bowel movements is increased and it is a soft stool that does not form, and it occurs mostly in the morning, and it takes 2 or 3 times to form soft stools. The rest of the day is the same as normal people.
Clinical classification of proctitis:
I degree: occasional blood in the stool, mucosal edema, irregular bowel movements, loose stools or constipation;
II degree: common blood in the stool, mucosal hypertrophy, rectal stenosis, difficulty in defecation, drug relief;
III degree: whole blood stool, ulcer or takeover formation, rectal stenosis, severe difficulty in bowel movements, and even obstruction.
