see also:

• ano-rectal pain
• tenesmus

• inflammation of the rectum

• ulcerative colitis
• Crohn's disease
• idiopathic ulcerative proctitis
• coeliac disease
• radiation
• ischaemic proctitis due to hypotensive episodes, anaphylaxis or systemic lupus erythematosus (SLE)
• non-steroidal anti-inflammatory drugs (NSAIDs)
• caustic agents such as cleaning solutions
• diversion proctitis - prior surgery leading to diversion of faecal flow from rectum eg. colostomy
• sexually transmitted infections (STDs/STIs)
  • gonococcus
  • chlamydia
  • Herpes simplex virus (HSV)
  • syphilis
  • Lymphogranuloma venereum

• rectal swabs for sexually transmitted infections (STDs/STIs)
• syphilis and HIV serology
• sigmoidoscopy with rectal biopsy
• +/- Ix as per coeliac disease
• exclude hypotension / ischaemic / radiation cause

• treat as per cause