Proctitis is inﬂammation of the lining of the rectum. Symptoms include bleed- ing, constipation, a feeling of fullness in the rectum, pain in the lower left abdomen or around the anus, and, sometimes, discharge of mucus and pus. Proc-titis may occur after certain medical treatments, such as radiation therapy or antibiotic use. Inﬂammatory bowel disease, sexually transmitted diseases, injury to the rectum, and infection also may cause proctitis.
Diagnosis of proctitis is made by a proctoscopy (see “Diagnostic Procedures,” page 282) and a biopsy (removal of a small piece of tissue for microscopic examination). Once the underlying cause of the inﬂammation has been deter- mined, the doctor will recommend appropriate treatment. If inﬂammatory bowel disease is the underlying cause, the doctor probably will prescribe corticosteroid medication to relieve the symptoms.
An abscess is an infected cavity ﬁlled with pus. Abscesses can occur when bac- teria penetrate and become trapped in the tissues of the anus or rectum. Anal abscesses that appear close to the tissue surface are very painful. Abscesses in deeper tissues tend to cause more general symptoms of infection such as fever, malaise (a vague feeling of being ill), and tenderness around the abscess. Your doctor will open and drain the abscess. When an anal abscess is drained, a ﬁstula (an abnormal connecting channel between the intestines and the skin in the gen- ital area) may develop spontaneously. Surgery is required to repair a ﬁstula.