Summary
Differentials
Common
- Idiopathic ulcerative proctitis
- Crohn proctitis
- Sexually transmitted proctitis
Uncommon
- Celiac disease
- Radiation proctitis
- Ischemic proctitis
- Proctitis related to nonsteroidal anti-inflammatory drug use, caustic agent
- Diversion colitis
- Mpox
Contributors
Authors
Jordan E. Axelrad, MD, MPH
Associate Professor of Medicine
Director of Clinical and Translational Research
Inflammatory Bowel Disease Center at NYU Langone Health
NYU Grossman School of Medicine
New York
NY
Disclosures
JEA declares research grants from BioFire Diagnostics; consultancy fees, honorarium, or advisory board fees from Biomerieux, Janssen, Pfizer, BMS, Adiso, Fresenius, and Abbvie. JEA is supported through the Clinical Investigator Research Award funded by the Crohn’s and Colitis Foundation (#878246), the Judith & Stewart Colton Center for Autoimmunity, and the NIH NIDDK Diseases K23DK124570.
Acknowledgements
Dr Jordan E. Axelrad would like to gratefully acknowledge Dr Alan C. Moss, a previous contributor to this topic.
Disclosures
ACM declares that he has no competing interests.
Peer reviewers
Srikrishna Nagri, MD
Gastroenterologist
Dartmouth-Hitchcock Nashua
Nashua
NH
Disclosures
SN declares that he has no competing interests.
Terry Bolin, MBBS
Associate Professor of Medicine
Gastrointestinal and Liver Unit
The Prince of Wales Hospital
Sydney
New South Wales
Australia
Disclosures
TB declares that he has no competing interests.
Peer reviewer acknowledgements
BMJ Best Practice topics are updated on a rolling basis in line with developments in evidence and guidance. The peer reviewers listed here have reviewed the content at least once during the history of the topic.
Disclosures
Peer reviewer affiliations and disclosures pertain to the time of the review.
References
Key articles
Workowski KA, Bachmann LH, Chan PA, et al; Centers for Disease Control and Prevention. Sexually transmitted diseases treatment guidelines, 2021. MMWR Recomm Rep. 2021;70:1-187.Full text Abstract
Daniel R, Mark P, Gauri G, et al. British Association of Sexual Health and HIV (BASHH) United Kingdom national guideline for the management of sexually transmitted enteric infections. International Journal of STD & AIDS. Aug 2023;34(9):588-602.Full text
Vries HJC, Nori AV, Larsen HK, et al. European guideline on the management of proctitis, proctocolitis and enteritis caused by sexually transmissible pathogens. J Eur Acad Dermatol Venereol. Jul 2021;35(7):1434-43.Full text
Lichtenstein GR, Loftus EV, Afzali A, et al. ACG clinical guideline: management of Crohn's disease in adults. Am J Gastroenterol. 2025 Jun 3;120(6):1225-64.Full text Abstract
American Society for Gastrointestinal Endoscopy Standards of Practice Committee, Shergill AK, Lightdale JR, et al. The role of endoscopy in inflammatory bowel disease. Gastrointest Endosc. 2015 May;81(5):1101-21.e1-13.Full text Abstract
Reference articles
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