Proctitis: An Approach to the Symptomatic Patient

Med Clin North Am. 2024 Mar;108(2):339-354. doi: 10.1016/j.mcna.2023.09.002. Epub 2023 Nov 1.

Abstract

Proctitis is an inflammatory condition of the distal rectum that can be associated with common sexually transmitted infections (STIs), such as gonorrhea, chlamydia, and syphilis. For persons presenting with ulcerative findings on examination, in addition to syphilis, Mpox, lymphogranuloma venereum, and herpes simplex virus should be in the differential. Providers should also be aware that there are evolving data to support a role for Mycoplasma genitalium in proctitis. Performing a comprehensive history, clinical evaluation including anoscopy, and rectal nucleic amplification STI testing may be useful in identifying the cause of proctitis and targeting treatment.

Keywords: Prevention; Proctitis; Sexually transmitted infection; Treatment.

Publication types

  • Review

MeSH terms

  • Humans
  • Lymphogranuloma Venereum* / complications
  • Lymphogranuloma Venereum* / diagnosis
  • Lymphogranuloma Venereum* / drug therapy
  • Proctitis* / diagnosis
  • Proctitis* / drug therapy
  • Proctitis* / etiology
  • Sexually Transmitted Diseases* / complications
  • Sexually Transmitted Diseases* / diagnosis
  • Sexually Transmitted Diseases* / therapy
  • Syphilis* / complications
  • Syphilis* / diagnosis
  • Syphilis* / drug therapy