Alimentary Tract: Clinical ReviewsDiagnosis and Treatment of Ulcerative ProctitisRegueiro, Miguel D MD Author Information From the Inflammatory Bowel Disease Center and Division of Gastroenterology, Hepatology, and Nutrition, University of Pittsburgh School of Medicine, Pennsylvania. Reprints: Miguel D. Regueiro, MD, Assistant Professor of Medicine, University of Pittsburgh School of Medicine, Medical Center 200, Lothrop Street, PUH-C Wing Mezzanine Level, Pittsburgh, PA 15212 (e-mail: [email protected]). Journal of Clinical Gastroenterology: October 2004 - Volume 38 - Issue 9 - p 733-740 doi: 10.1097/01.mcg.0000139178.33502.a3 Buy Metrics Abstract Proctitis refers to inflammation of the rectum, a diagnosis made by endoscopic evaluation. Symptoms of proctitis include rectal bleeding, urgency, tenesmus, diarrhea or constipation, and occasionally rectal pain. The causes of proctitis include infection, medication, ischemia, radiation, and ulcerative proctitis. Ulcerative proctitis is an important and increasingly common subcategory of ulcerative colitis (UC) in which inflammation is limited to the rectum. Historically, oral aminosalicylates have been the mainstay of acute and maintenance therapy. A growing body of data, however, indicates that topical aminosalicylates are effective first line agents in ulcerative proctitis and distal UC. Topical aminosalicylates act more effectively and rapidly to induce and maintain remission compared with their oral counterparts or topical steroids. Rarely ulcerative proctitis is refractory to topical therapy and in these instances systemic corticosteroids, antibiotics, immunomodulators, or surgery is required. This review highlights the pathogenesis, diagnosis, and treatment of ulcerative proctitis. © 2004 Lippincott Williams & Wilkins, Inc.