Proctitis diagnosis

Hello! I'm brand new to these forums, and I just had my first colonoscopy this morning and I have a few questions and I'm hoping someone who has more experience with this may be able to help.

After having symptoms such as severe abdominal pain, blood and mucus in stools, and diarrhea I was scheduled for my colonoscopy. I had the procedure done this morning and was told I have proctitis but I was still so out of it from the sedative that I don't quite remember everything the doctor said to me, and I did email him and I'm waiting for a reply.

I've read about the common causes of proctitis and I am 100% certain it has nothing to do with STDs or anything like that, which leaves either some other type of infection or an inflammatory bowel disease. My main question is can a GI doctor diagnose Crohn's or ulcerative colitis/proctitis with just the colonoscopy alone? Biopsies were taken so I'm curious if he's waiting on those results to find out for sure, or if he can tell based on appearance alone it's not Crohn's or UC. Also, can proctitis turn into UC? I'm just so confused how it happened, I have no prior history of any issues like this nor do they run in my family. I'm a 24 year old female.

Hi ccm1891 and welcome but sorry you have to be here!

Your GI should be running stool and blood tests as well, he may also order small bowel tests to check for crohn's, a C-scope alone isn't likely all he will do.

Often UC starts in the rectum (proctitis is inflammation in the rectum which can be caused by a few things as you mentioned) and commonly moves into the colon (inflammation in the colon is referred to as "colitis") Crohn's disease, unlike UC, can affect the entire GI tract from mouth to anus, so if you ever hear the term "crohn's colitis" that's CD affecting the colon. CD can affect different areas of the GI tract all at one time as well. CD has patchy inflammation, UC isn't patchy, instead the entire area will be inflamed, with CD it's patchy with healthy tissue (marbled/patchy) if you have crohn's colitis you won't necessarily have proctitis but it often accompanies it when CD is affecting the colon, but generally the rule with UC is that the disease starts in the rectum and moves into the colon.

I was about the same age as you when I became sick with CD, we didn't think it ran in our family either until my mom ended up with UC a few years after I was DX with CD....that said, it doesn't always run in families but there is definitely some genetic component involved, they still don't know enough about it so they cannot figure out how exactly it can be passed down.

Go online and google images of colitis, it looks like a cas has scratched up your guts.

ccm1891 said...
I've read about the common causes of proctitis and I am 100% certain it has nothing to do with STDs or anything like that, which leaves either some other type of infection or an inflammatory bowel disease. My main question is can a GI doctor diagnose Crohn's or ulcerative colitis/proctitis with just the colonoscopy alone? Biopsies were taken so I'm curious if he's waiting on those results to find out for sure, or if he can tell based on appearance alone it's not Crohn's or UC. Also, can proctitis turn into UC? I'm just so confused how it happened, I have no prior history of any issues like this nor do they run in my family. I'm a 24 year old female.

An STD isn't the only cause of proctitis, it can be a bowel disorder. Ulcerative colitis/proctitis is diagnosed by a stool test negative for pathogenic causes, a colonoscopy and a biopsy. Often, it is quite clear what it is based on the observations in the colonoscopy, but it can be inconclusive as well. He/she might be waiting for biopsy results and stool test results before making the call. Yes, it can spread and turn into full blown ulcerative colitis.

You should have a followup consultation with your doctor once all of the results are back in, and he/she will answer all of your questions and concerns. Mostly, I'd ask: do I have a chronic, lifelong condition or is this a one-time episode that'll clear up with the meds you prescribed me. Good luck, I hope it isn't a chronic lifelong disease!