Ulcerative proctitis

Abstract

Ulcerative proctitis is a non-specific inflammatory condition of a diffuse nature involving the mucosa of the rectum. It commences at the dentate line and extends proximally for a variable distance. By definition, the upper extent of the disease must be able to be seen at sigmoidoscopy. This is usually at a distance of 5 to 15 cm from the anal verge. The natural history of the condition is one of spontaneous remission after varying periods. This makes scientific assessment of therapy very difficult if not impossible. In a small proportion of patients (10% or less) the disease will extend to involve the colon. It is difficult to be certain whether this is true progression or inaccurate assessment of extent at the time of presentation. The treatment of the condition is non-specific. Reassurance of the patient with emphasis on the excellent prognosis is essential. Response to drug therapy is unpredictable and in many instances disappointing. Dietary manipulation is usually not required. Operative treatment is never indicated for proctitis. If extension of the disease occurs, operation may be required.