Proktit – inflammatory process in a zone of a mucous membrane of a rectum. Is a polietiologichesky disease. Is followed by frequent desires on a chair, unpleasant feelings during defecation, burning, an itch and feeling of a foreign matter in the field of an anus. At sharp forms the hyperthermia and symptoms of intoxication are observed, at a chronic proktit the general state is not broken. Proktit it is diagnosed on the basis of complaints, results of survey, a rectal and endoscopic research. Treatment – elimination of provocative factors, a diet, antimicrobic medicines, soothing and disinfecting medicines.
Proktit – the inflammation of a mucous rectum caused by violations of food, parasites, infectious damages of a GIT, bodies of a crotch and small pelvis, chronic diseases of system of digestion, surgical interventions, foreign matters in a zone of back pass, beam influence and other factors. Proktit can sharp, subsharp or chronic, however has a chronic current more often. It is quite often combined with an inflammation of a sigmovidny gut (proktosigmoidit) or pararectal cellulose (paraproktit). Exact information on prevalence of a proktit is absent. The disease equally often affects patients of both floors. Treatment is carried out by experts in the sphere of a proktologiya.
Reasons of a proktit
It is possible to allocate two groups of the factors causing development of a proktit – the general and local. Carry mechanical injuries, introduction of chemicals, hot or cold solutions to a rectum, transition of an infection from nearby bodies, and also rectum new growths to number of the local damaging factors. Proktit can cause mechanical injuries at unqualified massage or self-massage of a rectum and prostate gland, homosexual sexual intercourses and introduction of various objects to a rectum for the purpose of excitement and satisfaction.
Proktit, caused by influence of the irritating chemicals, hot and cold solutions, usually arises in treatment attempts by "folk remedies", the wrong or excessive use of enemas, rectal candles etc. As the "means of national treatment" provoking development of a proktit alcohol, turpentine, essential oils (clove, eucalyptus, peppermint oil), iodine solution, the concentrated solution of chloride of calcium, tincture on mustard and siliculose pepper can be used. All listed substances possess irritant action, at the same time patients quite often apply them to treatment of hemorrhoids, cracks of back pass and other diseases that aggravates the available pathology and becomes the reason of development of an inflammation mucous.
Proktit also can arise at contact spread of an infection from the inflamed vagina, an urethra, a bladder or pararectal cellulose. Along with nonspecific infectious agents, gonokokk, hlamidiya, trichomonads, etc. can act as the activator. The patients having oncological diseases, the cause of a proktit can have breaking-up malignant tumors of a rectum and other bodies of a crotch.
Experts include in the list of the general reasons of development of a proktit violations of food, a GIT infection, parasitic diseases, autoimmune diseases, disorders of motility, an innervation or blood supply of the lower departments of intestines and beam influences. The disease is more often diagnosed for the people abusing alcohol, spicy and spicy food. Proktit it can be found at such infectious diseases as salmonellosis, dysentery and , and also at an enteroviral infection. At the long course of the listed diseases proktit it is provoked not only by direct contact of pathogenic microorganisms with a mucous membrane of a rectum, but also long diarrhea, release of toxins and other general reasons.
In the list of the diseases of the autoimmune nature affecting a thick gut and capable to cause proktit, scientists include a disease Krone, nonspecific ulcer colitis, and Whipple's disease. Enter the list of parasitic diseases , , and . At the people who recently visited tropics, a provocative parasitic disease can become American , however in Russia such cases meet seldom.
Proktit quite often it is diagnosed for patients with dyskinesia of a thick gut and a syndrome of the angry gut, and also for the patients who underwent operations on bodies of a small pelvis or suffering from chronic violations of blood supply in this area. The probability of development of a proktit increases at diseases of a pancreas, liver and gall bladder. Radiation in the course of therapy of malignant neoplaziya of bodies of a small pelvis, most often – cancer of a body of a uterus and cancer of a neck of a uterus is one more reason of development of a proktit. The probability of developing of a disease directly depends on a radiation dose.
Classification of a proktit
Taking into account an etiologichesky factor allocate alimentary, infectious, parasitic, stagnant (arising at locks of various genesis), beam, gonorrheal, chlamydial and other types of a proktit. Depending on features of a current distinguish a sharp, subsharp and chronic form of a disease. Taking into account the nature of inflammatory process sharp proktit classify on:
- Catarrhal and mucous - at survey puffiness and reddening of a mucous membrane come to light; intensive release of slime is noted.
- Catarrhal and hemorrhagic - mucous it is edematous, hyperemic, covered with numerous small hemorrhages.
- Catarrhal and purulent - reddening and hypostasis mucous in combination with purulent allocations are observed.
- Gnoyno-fibrinozny - the inflamed mucous membrane becomes covered by badly removed is purulent-fibrinoznymi films.
- Erosive - on a surface of a mucous gut superficial defects are formed.
- Ulcer - on a surface mucous there are deep defects.
- Ulcer and necrotic - formation of deep defects is combined with formation of sites of a necrosis.
- Polipozny - is followed by emergence of the small outgrowths reminding rectum polyps.
Chronic proktit subdivide on:
- Hypertrophic - mucous it is thickened, the folds which bulked up, their depth it is increased; focal growths mucous come to light (false polyps).
- Atrophic - mucous pale, thinned, depth of folds is reduced. Appear through the vessels located in a submucous layer mucous.
- Normotrofichesky - comes to light the coloring change caused by a chronic inflammation. Thickness and a relief mucous without changes.
Atrophic and hypertrophic changes of a mucous membrane do it to more vulnerable. Emergence of the erosion and chronic ulcers covered with the bleeding granulations is possible. Formation of ulcers and the subsequent rough cicatricial changes can become the reason of perforation of a wall of intestines, deformation and a cicatricial stenosis of a rectum. At patients with a beam proktit of an ulcer can remind the breaking-up malignant new growth.
Symptoms of a proktit
In a stage of an aggravation pains and disorders of defecation are characteristic of a sharp and subsharp proktit, and also a chronic form of a disease. At a sharp proktit of pain can be rather intensive, at a subsharp and chronic current expressiveness of a pain syndrome decreases. Patients quite often experience difficulties in attempt to specify localization of pains. Complaints to pain in the lower part of a stomach, lumbar area and a zone of a crotch are possible, however during the detailed poll usually it becomes clear that the point of the greatest morbidity settles down in a zone of a sacrum or an anus. Pains amplify at the time of defecation and decrease after its termination. Are combined with burning in a zone of back pass which also is a constant symptom of a proktit.
Violations of defecation are shown in the form of false desires. At a sharp form of a disease desires constant, at subsharp – more rare. Chronic proktit in an aggravation phase, as a rule, proceeds rather softly in comparison with sharp. At an initial stage desires are combined with the locks caused by a spasm of a sphincter and fear of patients of intensive pains during defecation. In the subsequent the spasm of a sphincter is replaced by its relaxation, ponosa and an otkhozhdeniye of slime are possible during false desires. At erosive, ulcer and ulcer and necrotic forms in Calais blood quite often comes to light.
In hard cases complications in the form of bleeding, an intestines wall perforation with emergence of kalovy zatek, formation of fistulas or formation of a striktura of a rectum are possible. Rectal bleedings at a proktita seldom happen plentiful, but at frequent repetition can lead to development of anemia. At fistulas of a rectum the calla and gases through an urethra or a vagina is noted an otkhozhdeniye. At striktura of patients difficulties of defecation in combination with an incontience of intestinal contents, an itch and irritation of skin in perianalny area disturb.
Diagnostics of a proktit
The disease is diagnosed taking into account complaints, data of survey, a rectal research, radiological and endoscopic researches, and also results of laboratory analyses. At the initial stage the proctologist examines area of a crotch and back pass of the patient proktity, revealing inflammation signs, sites of maceration and so forth. Then the expert conducts a manual rectal research in the course of which the spasm or relaxation of a sphincter, puffiness mucous, narrowing of a gut and other pathological changes can be found. Visual assessment of such changes, definition of a type of a proktit and expressiveness of inflammatory process is carried out when carrying out a rektoromanoskopiya. If necessary during the endoscopic research the biopsy is carried out.
At suspicion appoint an irrigoskopiya or an irrigografiya to existence of a striktura of a rectum. Data of radiological researches confirm existence of characteristic narrowing at which the rectum reminds a narrow tube with rigid equal walls. For identification of pathological impurity, leukocytes, parasites and bacterial agents make analyses a calla. Proktit differentiate with hemorrhoids, paraproktity, polipozy, cancer of a rectum and some other diseases at which there can be an inflammation of a perianalny zone and a mucous membrane of the lower departments of a large intestine.
Treatment of a proktit
Treatment of a proktit conservative, is usually carried out in out-patient conditions, includes etiopatogenetichesky and symptomatic therapy. To patients appoint the sparing diet and a bed rest, recommend to avoid long stay in a sitting position. After improvement of a state advise to keep moderate physical activity. At severe forms of a sharp proktit (ulcer, ulcer and necrotic) at the initial stage hospitalization in a hospital is shown.
At parasitic proktita appoint antigelmintny means, at specific and nonspecific infections carry out antibacterial or antiviral therapy taking into account activator type. At chronic gastrointestinal diseases perform treatment of the main pathology. At a proktita apply spazmolitik to reduction of spasms, elimination of false desires and decrease in intensity of pains, if necessary – in combination with analgetics. Daily carry out cleaning enemas, and then – medical enemas with a camomile, a calendula, kollargoly, sea-buckthorn oil and other means. Medicine is selected taking into account a type of inflammatory process and a stage of an inflammation. Appoint sedentary trays. Use candles and aerosols with the regenerating action. After elimination of an acute inflammation by the patient proktity recommend sanatorium treatment.