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ulcerative proctitis
see Proctitis
Pathology:
- rectal mucosa may show
- loss of vascular markings
- erythema
- friability
- chronic inflammation
- crypt distortion, crypt atrophy
Clinical manifestations:
- diarrhea
- tenesmus
- fecal urgency
- rectal bleeding
Complications:
- little if any increased risk of colon cancer if inflammation is confined to rectum (contrast with ulcerative colitis)
Management:
- colon cancer screening per schedule without risk factors
- glucocorticoid rectal foam
- budesonide rectal foam
- 2 mg per 25 mL twice daily for 2 weeks, then once daily for 4 weeks [2]
- hydrocortisone rectal foam
- sulfasalazine
- folate supplementation with sulfasalazine
- sulfasalazine inhibits folate absorption [3]
Related
ulcerative colitis (UC)
General
proctitis (rectitis)
References
- Medical Knowledge Self Assessment Program (MKSAP) 16
American College of Physicians, Philadelphia 2012
- Sandborn WJ et al.
Budesonide foam induces remission in patients with mild to
moderate ulcerative proctitis and ulcerative proctosigmoiditis.
Gastroenterology 2015 Jan 30
PMID: 25644096
http://www.gastrojournal.org/article/S0016-5085%2815%2900154-7/abstract
- NEJM Knowledge+ Gastroenterology