Proctitis may develop secondary to rectal gonorrhea, candidiasis, syphilis, or nonspecific sexually transmitted infections. The most common causative pathogens are Neisseria gonorrhoeae, chlamydiae, and herpesvirus.

Other causes include chronic constipation, habitual laxative use, emotional upset, radiation therapy, endocrine dysfunction, rectal surgery, rectal medications, allergies, vasomotor disturbance that interferes with normal muscle control, and food poisoning.

Proctitis can lead to ulcerations, crypt abscesses, bleeding, fissures, and fistulas. Submucosal inflammation with fibrosis may occur, leading to stricture.

The patient typically complains of these key symptoms: constipation, a feeling of rectal fullness, and cramps in the left abdomen. The history may also reveal te-nesmus producing a few bloody or mucoid stools.