Sharp proktit – an acute inflammation of a mucous rectum. The sudden beginning is characteristic. The disease is shown by sharp pains, locks in combination with frequent false desires, burning and heavy feeling in a rectum, pathological allocations from back pass, violation of the general state, oznobama and a hyperthermia. Sharp proktit can come to an end with recovery or pass into a chronic form. It is diagnosed on the basis of complaints, the anamnesis, data of rectal survey and a rektoskopiya. Treatment – a diet, antibiotic treatment, local resolvents, enemas, sedentary bathtubs, sometimes – hormonal medicines.
Sharp proktit – the sharp inflammatory process in a zone of a mucous membrane of a rectum resulting from infection, existence of parasites, mechanical, chemical or beam influence. It is quite often combined with sigmoidity. Sometimes extends to hypodermic fatty cellulose in the field of an anus with development of a paraproktit. Also isolated forms of a sharp proktit meet defeat of the lower departments of a gut. Displays of a disease remain within several days or weeks (depending on a form and prevalence of inflammatory process). Recovery or development of a chronic proktit can become an outcome. Data on prevalence of a sharp proktit are absent. The disease equally often comes to light at patients of both floors. Treatment is performed by experts in the sphere of a proktologiya.
Reasons of a sharp proktit
This disease can be provoked by features of a diet, helminths, locks, infections, chemical and mechanical influences, and also radiation of a zone of a small pelvis. Development of a sharp proktit is promoted by a habit to the use of spicy food and tendency to abuse of alcoholic beverages. An essential role is played by the stagnation of fecal masses in a rectum which is followed by violations of venous outflow and mechanical damages mucous intestines.
Sharp proktit can arise against the background of helminthoses (an amebiaz, an askaridoz etc.), nonspecific and specific infectious processes. Among the specific infections capable to provoke sharp proktit, researchers specify gonorrhea. At the unprotected anal sexual contacts with the partner infected pale treponemy on mucous a rectum it can be formed primary syphilitic . Sharp beam proktit can come to light at the oncological patients undergoing radiation therapy concerning malignant tumors of bodies of a small pelvis.
Foreign matters in back pass, too hot and too cold cleaning enemas or enemas with the irritating substances causing an inflammation mucous become the reason of a sharp proktit sometimes. Development of a sharp proktit can be promoted by some diseases of area of an anus, nearby bodies and fabrics (paraproktit, the anal crack, hemorrhoids, vulvovaginit, cystitis), and also immune violations of various genesis and the weakening of an organism caused by overcooling, a physical and emotional overstrain.
Classification of a sharp proktit
Taking into account the nature of damage of a mucous rectum allocate the following types of a sharp proktit:
- Catarrhal and mucous – is followed by hyperaemia of a zone of defeat and release of slime.
- Catarrhal and hemorrhagic – hypostasis, hyperaemia and formation of multiple small hemorrhages in a defeat zone are observed.
- Catarrhal and purulent – is followed by hypostasis of a mucous membrane and formation of pus.
- Gnoyno-fibrinozny – reminds catarrhal and purulent sharp proktit, but differs from it in a consistence of pus at which there are large amounts of fibrin. Is followed by education it is purulent-fibrinoznykh films on a surface mucous.
- Erosive – is shown by formation of superficial defects of mucous.
- Ulcer – is followed by formation of deep defects of mucous.
- Ulcer and necrotic – represents heavy option of a sharp ulcer proktit at which on a mucous membrane of a rectum, along with ulcers, sites of a necrosis are formed.
- Polipozny – is shown by formation of the outgrowths, on appearance reminding intestines polyps.
Symptoms of a sharp proktit
The sudden beginning with deterioration in the general state, a hyperthermia, oznoba and locks in combination with tenezma is characteristic of this disease. Patients with a sharp proktit are disturbed by the intensive pains in a defeat zone amplifying at the time of defecation. Pains can irradiate in a crotch and genitals. Irradiation to the lumbar area is less often noted. Many patients with a sharp proktit complain of burning and weight in a rectum. Pathological allocations from back pass are possible.
Expressiveness and time of emergence of symptoms can differ depending on type and the reason of development of a disease. Sharp proktit, caused by mechanical, chemical or thermal injury of a rectum, arises in several hours or days after an adverse effect. The delayed emergence of symptomatology is characteristic of a beam proktit (usually – in several weeks or months after completion of radiation therapy). Sharp proktit, caused by alimentary factors, constant locks or chronic inflammatory processes, can arise against the background of a usual state, in the period of an aggravation or after especially gross violation of a diet.
Body temperature of patients with a sharp proktit is more often subfebrilny. The expressed hyperthermia with strong oznoba usually comes to light at purulent and ulcer forms of a disease. At a mucous sharp proktit release of slime is observed, at purulent – release of pus. At ulcer and ulcer and necrotic forms in Calais impurity of fresh blood or blood clots are found. Development of a beam proktit is followed by emergence of bloody allocations, weights and burnings in the struck area.
At a sharp proktit the tendency to spastic reduction of a sphincter at initial stages of a disease and to its subsequent excessive relaxation in process of increase of symptomatology is noted, however, at different forms of a disease expressiveness of this sign can differ. Duration of a sharp proktit can also vary. At an easy superficial inflammation all symptoms disappear within several days. At erosive, ulcer and ulcer and necrotic forms perhaps long current. The absolute recovery or transition in chronic can become an outcome of a sharp proktit proktit.
Diagnostics of a sharp proktit
The disease is diagnosed on the basis of clinical symptoms, the given manual research of a rectum and additional diagnostic procedures. When carrying out a manual research at patients with a sharp proktit spasmodic reduction or relaxation of a sphincter, puffiness and infiltration of mucous come to light. After extraction of a finger on a glove traces of blood and slime are found. At a rektoskopiya puffiness and hyperaemia mucous, erosion, ulcers, hemorrhages etc. are visualized.
When performing endoscopy the doctor carries out an endoscopic biopsy for the subsequent histologic research of material. Except the listed researches, in the course of diagnostics of a sharp proktit use analyses a calla on and on existence of eggs of worms (for definition of the reason of development of a disease and the choice of the most effective medical tactics). The differential diagnosis is carried out with malignant tumors of a rectum and an abstsediruyushchy furuncle of a crotch.
Treatment of a sharp proktit
Treatment is conservative. Advise patients to refuse the use of greasy, salty, spicy, sour and sweet food and products with the high content of rough cellulose. Appoint the sparing diet providing the use of the low-fat wiped meat, fast liquid and semi-fluid dishes. At initial stages of a sharp proktit the proctologist recommends rest, in the subsequent – moderate physical activity which promotes prevention of stagnation of kalovy masses in a rectum. Indicate the need to exclude long stay in a sitting position.
Perform antibiotic treatment taking into account sensitivity of the flora allocated at crops of intestinal contents. At the sharp proktit caused by specific infections carry out the corresponding therapy, at helminthoses appoint antigelmintny means. Apply the antihistaminic and spazmolitichesky medicines eliminating a rectum spasm. Use candles with the resolvents and components promoting restoration mucous and also cleaning enemas with a camomile and sedentary trays with potassium permanganate solution. At ulcer forms of a sharp proktit inject hormonal drugs of local action.