Proctitis in Emergency Medicine Follow-up
- Author: Lisandro Irizarry, MD, MPH, FAAEM; Chief Editor: Robert E O'Connor, MD, MPH more...
Further Outpatient Care
- Discharge if no life-threatening condition exists and the patient is able to comply with the therapeutic regimen.
- Discharge should include follow-up with a colorectal surgeon or gastroenterologist who will monitor the patient's progress clinically and endoscopically, in addition to following results of cultures, labs, and biopsies.
Inpatient & Outpatient Medications
- Maintenance medical therapy is not used routinely in idiopathic proctitis unless the patient's condition is slow to respond, difficult to control, or has frequent flare-ups.
- In radiation proctitis, there is no evidence that indicates that corticosteroids and/or various aminosalicylic acid derivations given as an enema or orally are beneficial in preventing the progression of the disease.
- In hemorrhagic proctitis, formaldehyde is effective in controlling bleeding with no serious complication, but further studies are needed.[4]
Complications
Complications of proctitis may include the following:
- Chronic ulcerative colitis
- Fistula formation
- Abscess
- Treatment failure
- Perforation
Prognosis
- Failure rates as high as 35% have been reported following treatment of rectal gonorrhea; symptoms frequently recur.
- Most surgeons favor a diverting colostomy for medically intractable proctitis.
Patient Education
- For excellent patient education resources, visit eMedicine's Esophagus, Stomach, and Intestine Center. Also, see eMedicine's patient education articles, Anal Abscess, Rectal Pain, and Rectal Bleeding.
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