Causes of Proctitis – Why Your Rectum Might Get Inflamed

Proctitis feels uncomfortable, but you don’t always need a doctor’s visit to understand what’s going on. Most of the time the cause is something you’ve either been exposed to or a condition already affecting your gut. Below we break down the biggest culprits, why they matter, and what you can do about them.

Common Infectious Causes

Infections are the top reason people develop proctitis. Bacterial, viral, and parasitic bugs all love the moist, warm environment of the rectum.

Sexually transmitted infections (STIs) such as gonorrhea, chlamydia, herpes, and syphilis often cause inflammation after anal intercourse. These germs can irritate the lining, leading to pain, bleeding, and discharge. If you notice any of those signs after unprotected sex, get tested right away.

Gastrointestinal bacteria like Campylobacter, Shigella, and Salmonella can travel down the digestive tract and settle in the rectum. Food poisoning or a recent bout of diarrhea can be the hidden trigger.

Viral infections such as cytomegalovirus (CMV) or the hepatitis viruses sometimes cause proctitis, especially in people with weakened immune systems. The virus attacks the cells lining the rectum, resulting in ulcer‑like sores.

Parasites like Entamoeba histolytica (the cause of amebiasis) are less common in North America but still show up in travelers. A single contaminated water source can introduce these bugs, which then inflame the rectal wall.

Non‑Infectious Triggers

Not all proctitis comes from germs. A number of chronic conditions and lifestyle factors can irritate the rectum without an infection.

Inflammatory bowel disease (IBD) – both ulcerative colitis and Crohn’s disease can involve the rectum. In these cases, the immune system mistakenly attacks the gut lining, causing ongoing inflammation, bleeding, and urgency.

Irritable bowel syndrome (IBS) doesn’t cause true inflammation, but severe cramping and frequent bowel movements can worsen a pre‑existing irritation, making proctitis symptoms feel worse.

Radiation therapy aimed at pelvic cancers (prostate, cervical, or colorectal) often damages healthy tissue. The rectal lining can become inflamed months after treatment finishes.

Medications such as non‑steroidal anti‑inflammatory drugs (NSAIDs), antibiotics, and some chemotherapy agents can wear down the protective mucus layer, exposing the rectal wall to irritants.

Diet and habits matter too. Very spicy foods, excessive alcohol, or chronic constipation can all increase pressure on the rectal wall, leading to micro‑tears and inflammation.

Finally, anal hygiene plays a role. Over‑washing with harsh soaps or using scented wipes can strip natural oils, while not cleaning enough can leave bacteria to multiply.

Knowing these triggers helps you pinpoint what might be causing your proctitis. If an infection is suspected, a simple test can confirm it and guide treatment. For chronic conditions like IBD, managing the underlying disease usually eases the rectal inflammation as well.

Bottom line: proctitis isn’t mysterious. It’s usually an infection you caught, a chronic gut disease you already have, or something in your lifestyle that’s irritating the rectal lining. Identify the likely cause, talk to a healthcare professional, and you’ll be on the road to relief faster than you think.