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Separating Infectious Proctitis from Inflammatory Bowel Disease-A Common Clinical Conundrum

Hall, R; Patel, K; Poullis, A; Pollok, R; Honap, S (2024) Separating Infectious Proctitis from Inflammatory Bowel Disease-A Common Clinical Conundrum. MICROORGANISMS, 12 (12). p. 2395. ISSN 2076-2607 https://doi.org/10.3390/microorganisms12122395
SGUL Authors: Pollok, Richard Charles G

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Abstract

Proctitis refers to inflammation in the rectum and may result in rectal bleeding, discharge, urgency, tenesmus, and lower abdominal pain. It is a common presentation, particularly in genitourinary medicine and gastroenterology, as the two most common causes are sexually transmitted infections and inflammatory bowel disease. The incidence of infective proctitis is rising, particularly amongst high-risk groups, including men who have sex with men, those with HIV seropositive status, and those participating in high-risk sexual behaviours. The most commonly isolated organisms are Neisseria gonorrhoeae, Chlamydia trachomatis, Treponema palladium, herpes simplex virus, and Mycoplasma genitalium. Recently, proctitis was also identified as a common feature during the Mpox outbreak. Distinguishing infective proctitis from inflammatory bowel disease remains a significant clinical challenge as there is significant overlap in the clinical presentation and their endoscopic and histological features. This review compares and highlights the distinguishing hallmarks of both inflammatory and infective causes of proctitis. It provides a practical guide to describe the key features that clinicians should focus on in both clinical and key diagnostic investigations to avoid potential misdiagnosis.

Item Type: Article
Additional Information: © 2024 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
Keywords: proctitis, inflammatory bowel disease, sexually transmitted infection, lymphogranuloma venereum, <italic>Chlamydia trachomatis</italic>, <italic>Neisseria gonorrhoeae</italic>, Mpox
SGUL Research Institute / Research Centre: Academic Structure > Infection and Immunity Research Institute (INII)
Journal or Publication Title: MICROORGANISMS
ISSN: 2076-2607
Publisher License: Creative Commons: Attribution 4.0
Web of Science ID: WOS:001384676000001
URI: https://openaccess.sgul.ac.uk/id/eprint/117065
Publisher's version: https://doi.org/10.3390/microorganisms12122395

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