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What to Know About Ulcerative Proctosigmoiditis

Medically Reviewed by Dan Brennan, MD on June 12, 2021

There are four types of ulcerative colitis. Proctosigmoiditis is one of the types that affect the lower end of the colon. Ulcerative colitis is an inflammatory bowel disease (IBD) that can flare up and needs lifelong management. 

What Is Ulcerative Colitis?

Ulcerative colitis is a chronic disease that causes inflammation and ulcers in your digestive tract. This condition requires lifelong management and has no current cure. However, with treatment, you can reduce the symptoms and eventually get into remission.

If you’re dealing with ulcerative colitis, you’ll experience potentially painful flare-ups that come and go. There will be periods when you don’t feel any pain or symptoms at all until your next flare-up comes. 

The periods between ulcerative colitis symptoms are called remission. Periods of remission can last months or, in some cases, years. However, there’s not a cure, and flare-ups will come back.   

What Is Proctosigmoiditis?

Ulcerative proctosigmoiditis is one of the four types of ulcerative colitis. Proctosigmoiditis causes inflammation in your colon and rectum. This type is different from ulcerative proctitis, which is confined to your rectum.

Proctosigmoiditis causes inflammation that starts at your rectum and goes into the lower part of your colon near your sigmoid colon. Most of your symptoms will be felt in the left side of your abdomen. You’ll also experience appetite loss, weight loss, and bloody diarrhea.  

Signs and Symptoms of Proctosigmoiditis

Beyond the symptoms listed above, proctosigmoiditis also makes it difficult for you to have bowel movements even if you feel like you have to. Your symptoms will vary depending on how severe your inflammation is in your colon and rectum. 

Ulcerative colitis is the overall term for this condition. It's a type of IBD that causes many gastrointestinal problems. You might experience these symptoms, or you could have more localized symptoms with proctosigmoiditis. Common signs and symptoms of ulcerative colitis, in general, include: 

  • Weight loss
  • Fatigue
  • Fever
  • Diarrhea with blood or pus in it 
  • Abdominal pain and cramps
  • Rectal pain
  • Rectal bleeding — passing a small amount of blood with stool
  • Urgent need to have a bowel movement
  • Inability to have a bowel movement despite needing to 

Proctosigmoiditis is a milder type of ulcerative colitis. Depending on how much of your colon and rectum is affected, the symptoms can be less severe. However, the flare-ups can cause a lot of pain and can affect your health-related quality of life. 

Health Factors That Affect Proctosigmoiditis

If you have been diagnosed with ulcerative proctosigmoiditis, you may wonder what caused it. Some people believe food or stress causes it, which is a common misconception. While certain foods can upset your gastrointestinal tract, like stress, they are not the cause. There’s not a specific cause of ulcerative colitis, but there are factors that put you at risk. 

Heredity. You’re more likely to get ulcerative colitis if your family has it too. Though in some cases, you might be the first in your family, you're at higher risk if your parents or siblings have it. 

Age. You’ll typically be diagnosed with ulcerative colitis before 30. But you can get it later in life. This condition can affect anyone, regardless of age. 

Race or ethnicity. People who are white have a higher risk of getting ulcerative colitis. However, you have an even higher risk if you’re of Ashkenazi Jewish descent. 

Immune system malfunction. Another potential cause of proctosigmoiditis is when your immune system attempts to fight off a virus or bacteria but attacks your digestive cells too. Instead of fighting off the disease, your immune system goes after your digestive tract

Treatment for Proctosigmoiditis

There is no cure for ulcerative proctosigmoiditis, but there are treatment plans. These treatment plans aim to help you get to remission and have fewer flare-ups. Once you’re diagnosed with ulcerative colitis, it’s a lifelong prognosis. 

Treatment includes rectal therapy, which involves high concentrations of medication that reduces inflammation. The medication is designed to help you go into remission and reduce your chance of flare-ups. 

If you have internal bleeding or other complications in your gastrointestinal tract, your doctor may recommend surgery. The surgery would only be recommended in severe cases. It may include removing part or all of your colon or rectum, which is called a proctocolectomy. 

Based on your diagnosis and the amount of colon and rectum affected, your doctor will help you determine the right treatment plan. If you are experiencing severe pain and rectal bleeding, you should seek immediate medical attention. 

WebMD Medical Reference

Sources

SOURCES:

Crohn’s & Colitis Foundation: “Signs and Symptoms of Ulcerative Colitis,” “Types of Ulcerative Colitis.”

GI Society: “Ulcerative Proctitis.”

Inflammatory Bowel Diseases: “Medical Therapy of Ulcerative Proctitis and Proctosigmoiditis, Including Refractory Disease.”

Seminars in Gastrointestinal Disease: “Medical management of ulcerative proctitis, proctosigmoiditis, and left-sided colitis.”

Mayo Clinic: “Ulcerative colitis.”

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