What is proctosigmoiditis?

Proctosigmoiditis is a form of ulcerative colitis and affects the rectum and sigmoid colon (the S-shaped last part of the large intestine, leading into the rectum).

It is a lifelong chronic condition which cannot currently be cured and is part of a group of conditions known as inflammatory bowel disease (IBD). UC causes inflammation of the gastrointestinal tract (gut).

In UC small ulcers can develop on the colon’s lining which produce pus and mucus. This can cause abdominal discomfort and frequent emptying of the colon (diarrhoea).

Around 50% of people with UC are diagnosed with ulcerative proctitis or proctosigmoiditis.

What are the symptoms of proctosigmoiditis?

Typical symptoms include:

• Rectal bleeding
• Urgency to go to empty your bowels
• Tenesmus - feeling the need to pass stools despite bowel being empty
• Moderate pain on lower left side of abdomen
• Bloody diarrhoea and cramps

What treatments are there for proctosigmoiditis?

Treatments currently include medication and surgery. Some people have severely inflamed or damaged parts of their colon surgically removed. This can reduce or eliminate the symptoms of proctosigmoiditis, however it does not get rid of the disease and there is a risk that it will return to another area of the colon in the future.

Some people also make adjustments to their diet and lifestyle to support their medical treatment - such as exercise, improving quality of sleep, reducing stress.

What complications can occur with proctosigmoiditis?

• Cancer: People with ulcerative colitis have a greater risk of developing bowel cancer, particularly if they have been suffering with UC for a number of years
• Colectomy surgery: It is also associated with a higher instance of colectomy (where all or part of your colon is surgically removed).
• Toxic megacolon: The colon can acutely dilate when the inflammation becomes very severe - known as toxic megacolon. Symptoms include fever, abdominal pain and distention, dehydration and malnutrition. With toxic megacolon there is a risk of colonic rupture
• Anaemia: Blood loss from the inflamed intestines can lead to anaemia which can be treated with iron supplements or sometimes blood transfusions