Proctitis due to Crohn’s disease

Proctitis due to Crohn’s disease

Crohn’s disease can occasionally a ff ect the rectum, although classically it is spared. Sigmoidoscopic appearances di ff er from those in non-specific proctitis. The inflammatory process tends to be patchy rather than confluent, and there may be fissuring, ulceration or even a cobblestone appearance. Rectal Crohn’s disease is often associated with severe perineal disease characterised by fistulation, fissuring and haemorrhoids. Proctitis /uni25CF /uni25CF /uni25CF /uni25CF /uni25CF Coexistent disease is often present in the rest of the colon or small bowel, or both (see Chapter 75 ).

May be non-speci /f_i c or related to a speci /f_i c infective agent Non-speci /f_i c proctitis usually remains con /f_i ned to the distal bowel but can involve the proximal colon Symptoms include defecatory frequency, loose stools, bleeding and tenesmus Endoscopic assessment with biopsy is required to establish the diagnosis Treatment usually involves medical management