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• #1 Proctitis Information | Mount Sinai – New York

  https://www.mountsinai.org/health-library/diseases-conditions/proctitis

  Proctitis is an inflammation of the rectum. It can cause discomfort, bleeding, and the discharge of mucus or pus. […] There are many causes of proctitis. They can be grouped as follows: Inflammatory bowel disease, Autoimmune disease, Harmful substances, Non-sexually transmitted infection, Sexually transmitted disease (STD). […] Proctitis caused by an STD is common in people who have anal intercourse. STDs that can cause proctitis include gonorrhea, herpes, chlamydia, and lymphogranuloma venereum. […] Autoimmune proctitis is linked to diseases such as ulcerative colitis or Crohn disease. If the inflammation is in the rectum only, it may come and go or move upward into the large intestine. […] Proctitis may also be caused by some medicines, radiotherapy to prostate or pelvis or inserting harmful substances into the rectum.

• #1 Proctitis: What it is, Symptoms, Causes & Treatment

  https://my.clevelandclinic.org/health/diseases/5964-proctitis

  Proctitis has several possible causes, some more common than others. […] Common causes of proctitis include: Inflammatory bowel disease (IBD). Crohns disease and ulcerative colitis cause chronic inflammation in different parts of your bowels. Up to 30% of people affected by one of these diseases experience inflammation primarily in their rectum. This is the most common cause of proctitis overall. […] Sexually-transmitted infections (STIs). Sexually-transmitted viral infections and bacterial infections can reach your rectum through your anus, including: Gonorrhea, Chlamydia, Herpes simplex 2, Syphilis, Human papilloma virus (HPV). […] Gastrointestinal infections. Bacterial infections from food poisoning in your intestines may occasionally affect your rectum, including: Salmonella, Shigella, Campylobacter.

• #1 Proctitis, Proctocolitis, and Enteritis – STI Treatment Guidelines

  https://www.cdc.gov/std/treatment-guidelines/proctitis.htm

  Proctitis is inflammation of the rectum (i.e., the distal 1012 cm) that can be associated with anorectal pain, tenesmus, or rectal discharge. […] Proctitis occurs predominantly among persons who have receptive anal exposures (oral-anal, digital-anal, or genital-anal). […] N. gonorrhoeae, C. trachomatis (including LGV serovars), HSV, and T. pallidum are the most common STI pathogens. […] M. genitalium has been detected in certain cases of proctitis and might be more common among persons with HIV infection. […] N. meningitidis has been identified as an etiology of proctitis among MSM with HIV infection. […] The pathogenic role of M. genitalium in proctitis is unclear. […] Acute proctitis among persons who have anal exposure through oral, genital, or digital contact is usually sexually acquired.

• #1 Proctitis – Augusta HealthSearchClose SearchSearch IconSearch IconClose Search IconMobile Menu IconMobile Menu Close IconInstagramFacebookTwitterYoutube

  https://www.augustahealth.com/disease/proctitis/

  Proctitis is common in people who have inflammatory bowel disease (Crohn’s disease or ulcerative colitis). Sexually transmitted infections are another frequent cause. Proctitis also can be a side effect of radiation therapy for certain cancers. […] Several diseases and conditions can cause inflammation of the rectal lining. They include: […] Inflammatory bowel disease. About 30% of people with inflammatory bowel disease (Crohn’s disease or ulcerative colitis) have inflammation of the rectum. […] Infections. Sexually transmitted infections, spread particularly by people who engage in anal intercourse, can result in proctitis. Sexually transmitted infections that can cause proctitis include gonorrhea, genital herpes and chlamydia. Infections associated with foodborne illness, such as salmonella, shigella and campylobacter infections, also can cause proctitis.

• #1 Radiation proctitis | University of Iowa Health Care

  https://uihc.org/health-topics/radiation-proctitis

  Proctitis is inflammation of the lining of the rectum and has a variety of causes. When this kind of inflammation occurs because of exposure to ionizing radiation, the condition is called radiation proctitis. […] Radiation proctitis is a complication of radiation therapy. Those who have had radiation directed at their rectum or at areas around their rectum have increased risk of developing radiation proctitis. This includes areas such as the colon, prostate, cervix, or ovaries. […] In addition to radiation a variety of other conditions can cause proctitis.

• #1 Proctitis — symptoms, causes and treatment | healthdirect

  https://www.healthdirect.gov.au/proctitis

  Proctitis can be caused by sexually transmitted infections, gastrointestinal infections, ulcerative colitis or radiation therapy. […] Proctitis can be caused by: sexually transmitted infections (STIs) gonorrhoea, chlamydia, herpes, Mpox, syphilis or mycoplasma genitalium, gastrointestinal infections in your gut shigella, campylobacter or clostridioides difficile (also known as clostridium difficile), inflammatory bowel diseases ulcerative colitis or Crohn’s disease, coeliac disease, radiation therapy to your pelvic area. […] You can get infectious proctitis if you have unprotected anal sex with somebody who has an STI. […] Radiation proctitis can be acute or chronic. Acute proctitis develops when you are going through radiation therapy. It goes away when you finish treatment. Chronic radiation proctitis develops after you have finished radiation therapy. Your symptoms can be severe and difficult to treat, affecting your quality of life.

• #1 Proctitis – Augusta HealthSearchClose SearchSearch IconSearch IconClose Search IconMobile Menu IconMobile Menu Close IconInstagramFacebookTwitterYoutube

  https://www.augustahealth.com/disease/proctitis/

  Radiation therapy for cancer. Radiation therapy directed at your rectum or nearby areas, such as the prostate, can cause rectal inflammation. Radiation proctitis can begin during radiation treatment and last for a few months after treatment. Or it can occur years after treatment. […] Antibiotics. Sometimes antibiotics used to treat an infection can kill helpful bacteria in the bowels, allowing the harmful Clostridium difficile bacteria to grow in the rectum. […] Diversion proctitis. Proctitis can occur in people following some types of colon surgery in which the passage of stool is diverted from the rectum to a surgically created opening (stoma). […] Food protein-induced proctitis. This can occur in infants who drink either cow’s milk- or soy-based formula. Infants breast-fed by mothers who eat dairy products also may develop proctitis. […] Eosinophilic proctitis. This condition occurs when a type of white blood cell (eosinophil) builds up in the lining of the rectum. Eosinophilic proctitis affects only children younger than 2.

• #1 Proctitis: Causes, Treatment, and Surgery

  https://www.healthline.com/health/proctitis

  Proctitis is usually caused by underlying medical conditions. These include: sexually transmitted infections (STIs) […] inflammatory bowel disease (IBD), such as Crohns disease or ulcerative colitis […] anal trauma, such as from vigorous anal sex […] infections that arent sexually transmitted, such as infections from bacteria like salmonella and shigella […] rectal infections that occur after antibiotic use, such as from the bacteria Clostridium difficile […] radiation treatments for ovarian, anal, rectal, or prostate cancer. About 30 percent of people who have IBD also have proctitis at some point.

• #1 Ulcerative Colitis vs Proctitis: What’s the Difference?

  https://www.webmd.com/ibd-crohns-disease/ulcerative-colitis/ulcerative-colitis-vs-proctitis

  Both ulcerative colitis and the other type of IBD, Crohn’s disease, cause proctitis. About 30% of people with IBD have proctitis. […] Ulcerative colitis and Crohns disease are the most common causes of proctitis. Other possible causes include: […] Sexually transmitted diseases (STDs). The bacteria or viruses that cause gonorrhea, genital herpes, syphilis, and chlamydia can get into the rectum during anal sex and cause inflammation. […] Radiation therapy. People who have radiation therapy to their pelvis to treat prostate or gynecologic cancer can develop inflammation in the rectum. […] Poor blood flow. Ischemic proctitis is a type caused by reduced blood flow to the rectum. It most often affects older adults. […] Antibiotics. When you take these medicines to control an infection, they can change the balance of good and bad bacteria in your gut. Too much of the harmful bacteria Clostridioides difficile (C. diff) grows and crowds out more helpful bacteria. C. diff bacteria irritate the intestine wall.

• #1 Proctitis and Anusitis – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK430892/

  Proctitis and anusitis may happen secondary to ulcerative colitis (UC), Chronic Radiation Proctitis, Proctopathy (CRP), or Diversion Proctitis (DP). Infectious causes include Clostridium difficile, enteric infections (Campylobacter, Shigella, Escherichia coli, Salmonella, and amebiasis), and STIs (Gonorrhea, Chlamydia, Syphilis, HSV, Lymphogranuloma venereum, chancroid, CMV, HPV). […] Other causes include ischemia, vasculitis, toxins as hydrogen peroxide enemas or medication side effects. The most common cause of anusitis is diet, as with excess citrus, coffee, cola, beer, garlic, spices, and sauces. Diarrhea noted after intake of laxatives as in preparation for colonoscopy is noted to cause anusitis and stress may be another etiologic factor.

• #1 Proctitis – What You Need to Know

  https://www.drugs.com/cg/proctitis.html

  Proctitis may be a short-term or long-term condition. […] Intestinal diseases: Ulcerative colitis and Crohn disease are autoimmune conditions that may cause proctitis. […] Infections: Intestinal infections or sexually transmitted infections (STIs) may cause proctitis. […] Medicines: These include NSAIDs, antibiotics, chemotherapy, and medicine used to clear out your bowel. […] Trauma: This can occur from an injury or from putting objects in your rectum. […] Radiation treatment: Radiation to your pelvic area may damage your rectal tissues and blood vessels, causing proctitis. It may occur months or years after your treatment. […] Food allergies: These may easily upset any part of your bowel and cause proctitis and proctocolitis.

• #1 Proctitis: What it is, Symptoms, Causes & Treatment

  https://my.clevelandclinic.org/health/diseases/5964-proctitis

  Radiation therapy for cancer can cause radiation mucositis anywhere in your gastrointestinal tract. […] Some less common causes of proctitis include: Diversion proctitis. This side effect can occur in people whove had a colostomy or ileostomy that diverted their poop away from their rectum. […] Eosinophilic gastrointestinal disorders (EGID). Eosinophilia is when your body produces an abnormally high number of white blood cells (eosinophils). […] Idiopathic proctitis. In a small percentage of people, no direct cause for proctitis can be found. However, these cases often respond to dietary changes.

• #1 Separating Infectious Proctitis from Inflammatory Bowel Disease—A Common Clinical Conundrum

  https://www.mdpi.com/2076-2607/12/12/2395

  Proctitis refers to inflammation in the rectum and may result in rectal bleeding, discharge, urgency, tenesmus, and lower abdominal pain. […] The two most common causes of patients presenting with proctitis are infective causes and inflammatory bowel disease (IBD). […] Infective proctitis is usually caused by sexually transmitted infections. […] The most commonly isolated organisms causing infective proctitis are Neisseria gonorrhoeae, Chlamydia trachomatis, and Treponema pallidum. […] Infective proctitis predominately occurs in patients with a history of receptive anal sex leading to direct inoculation. […] Other risk factors for the development of infective proctitis include HIV seropositive status, sexually transmitted infections in the previous six months, unprotected receptive anal intercourse, and traumatic sex.

• #1 Proctitis – ADH North Shore

  https://northshoregastro.com/conditions-and-diseases/proctitis/

  Proctitis refers to an inflammation in the lining of the rectum (rectal mucosa), which can cause rectal pain and bleeding. Proctitis can be chronic, with long-term symptoms, or acute, with symptoms that last a short period of time. Some of the more common causes of proctitis include: […] Sexually transmitted diseases (STDs). This is one of the more common reasons proctitis can develop. Sexually transmitted diseases can be passed through anal sex, such as gonorrhea, chlamydia, syphilis, and herpes. These STDs can cause proctitis to occur. In patients with HIV and herpes, proctitis can be very severe. […] Other types of infection. Proctitis can occur from infections other than STDs. Foodborne bacteria, such as Salmonella and Shigella, can cause it, and Streptococcal proctitis can occur in children who have strep throat.

• #1 Proctitis – Diagnosis & treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/proctitis/diagnosis-treatment/drc-20376938

  Treatment for proctitis depends on the underlying cause of the inflammation. […] Your doctor may recommend medications to treat your infection. Options may include: […] For proctitis caused by bacterial infections, your doctor may recommend an antibiotic, such as doxycycline (Oracea, Vibramycin, others). […] For proctitis caused by viral infections, such as the sexually transmitted virus herpes, your doctor may prescribe an antiviral medication, such as acyclovir (Sitavig, Zovirax, others). […] Mild cases of radiation proctitis may not require treatment. In other cases, radiation proctitis can cause severe pain and bleeding that requires treatment. […] Treatment of proctitis related to Crohn’s disease or ulcerative colitis is aimed at reducing the inflammation in your rectum. […] Your doctor may prescribe anti-inflammatory medications, either by mouth or as a suppository or enema, such as mesalamine (Asacol HD, Canasa, others) or corticosteroids such as prednisone (Rayos) or budesonide (Entocort EC, Uceris).

• #2 HIE Multimedia – Proctitis

  https://adamcertificationdemo.adam.com/content.aspx?productid=117&pid=1&gid=001139

  Proctitis is an inflammation of the rectum. It can cause discomfort, bleeding, and the discharge of mucus or pus. […] There are many causes of proctitis. They can be grouped as follows: Inflammatory bowel disease, Autoimmune disease, Harmful substances, Non-sexually transmitted infection, Sexually transmitted disease (STD). […] Proctitis caused by an STD is common in people who have anal intercourse. STDs that can cause proctitis include gonorrhea, herpes, chlamydia, and lymphogranuloma venereum. […] Autoimmune proctitis is linked to diseases such as ulcerative colitis or Crohn disease. […] Proctitis may also be caused by some medicines, radiotherapy to prostate or pelvis or inserting harmful substances into the rectum.

• #2 Acute Proctitis: Background, Pathophysiology, Etiology

  https://emedicine.medscape.com/article/775952-overview

  Proctitis has many causes. It may be a side effect of medical treatments like radiation therapy or antibiotics. Proctitis caused by sexually transmitted diseases (STDs) is transmitted through receptive anal intercourse and is most commonly due to gonorrhea and chlamydia, or less commonly lymphogranuloma venereum or herpes virus. Nonsexually transmitted causes include autoimmune disease of the colon, such as Crohn disease and ulcerative colitis, celiac disease, chemicals, rectal instrumentation, and trauma to the anorectal area. It may also occur as idiopathic proctitis. […] Causes of proctitis may include the following: N gonorrhoeae, C trachomatis, HSV 1 (10%) and HSV 2 (90%), Radiation therapy, Immunodeficiency disorders, Crohn disease, Syphilis (usually secondary), Papillomavirus, Amebiasis, Lymphogranuloma venereum, Ischemia, Toxins (eg, hydrogen peroxide enemas), Vasculitis, Cytomegalovirus (CMV), Clostridium difficile, Campylobacter species.

• #2 Proctitis – Augusta HealthSearchClose SearchSearch IconSearch IconClose Search IconMobile Menu IconMobile Menu Close IconInstagramFacebookTwitterYoutube

  https://www.augustahealth.com/disease/proctitis/

  Proctitis is common in people who have inflammatory bowel disease (Crohn’s disease or ulcerative colitis). Sexually transmitted infections are another frequent cause. Proctitis also can be a side effect of radiation therapy for certain cancers. […] Several diseases and conditions can cause inflammation of the rectal lining. They include: […] Inflammatory bowel disease. About 30% of people with inflammatory bowel disease (Crohn’s disease or ulcerative colitis) have inflammation of the rectum. […] Infections. Sexually transmitted infections, spread particularly by people who engage in anal intercourse, can result in proctitis. Sexually transmitted infections that can cause proctitis include gonorrhea, genital herpes and chlamydia. Infections associated with foodborne illness, such as salmonella, shigella and campylobacter infections, also can cause proctitis.

• #2 Separating Infectious Proctitis from Inflammatory Bowel Disease—A Common Clinical Conundrum

  https://www.mdpi.com/2076-2607/12/12/2395

  Proctitis refers to inflammation in the rectum and may result in rectal bleeding, discharge, urgency, tenesmus, and lower abdominal pain. […] The two most common causes of patients presenting with proctitis are infective causes and inflammatory bowel disease (IBD). […] Infective proctitis is usually caused by sexually transmitted infections. […] The most commonly isolated organisms causing infective proctitis are Neisseria gonorrhoeae, Chlamydia trachomatis, and Treponema pallidum. […] Infective proctitis predominately occurs in patients with a history of receptive anal sex leading to direct inoculation. […] Other risk factors for the development of infective proctitis include HIV seropositive status, sexually transmitted infections in the previous six months, unprotected receptive anal intercourse, and traumatic sex.

• #2 Radiation Proctitis: Causes, Symptoms & Treatment

  https://my.clevelandclinic.org/health/diseases/radiation-proctitis

  Radiation proctitis may develop as a complication of radiation therapy in your pelvic area. […] Late radiation proctitis usually develops because radiation therapy causes: Scar-like tissue to build up in your rectum or the surrounding tissues (fibrosis), Wide blood vessels (telangiectasia), Narrow arterioles.

• #2 Proctitis — symptoms, causes and treatment | healthdirect

  https://www.healthdirect.gov.au/proctitis

  Proctitis can be caused by sexually transmitted infections, gastrointestinal infections, ulcerative colitis or radiation therapy. […] Proctitis can be caused by: sexually transmitted infections (STIs) gonorrhoea, chlamydia, herpes, Mpox, syphilis or mycoplasma genitalium, gastrointestinal infections in your gut shigella, campylobacter or clostridioides difficile (also known as clostridium difficile), inflammatory bowel diseases ulcerative colitis or Crohn’s disease, coeliac disease, radiation therapy to your pelvic area. […] You can get infectious proctitis if you have unprotected anal sex with somebody who has an STI. […] Radiation proctitis can be acute or chronic. Acute proctitis develops when you are going through radiation therapy. It goes away when you finish treatment. Chronic radiation proctitis develops after you have finished radiation therapy. Your symptoms can be severe and difficult to treat, affecting your quality of life.

• #2 Symptoms & Causes of Proctitis – NIDDK

  https://www.niddk.nih.gov/health-information/digestive-diseases/proctitis/symptoms-causes

  Different types of proctitis have different causes. […] Proctitis of inflammatory bowel disease. Two types of inflammatory bowel disease ulcerative colitis and Crohns disease may cause proctitis. […] Infectious proctitis. Several sexually transmitted diseases (STDs) can infect the rectum and cause proctitis, including gonorrhea, chlamydia, genital herpes, and syphilis. […] Other infections in the rectum that can cause proctitis include infections that cause food poisoning, such as Salmonella, Shigella, and Campylobacter infections. […] Radiation proctitis or radiation proctopathy. Radiation therapy to treat cancer in your pelvic area or lower abdomen may cause radiation proctopathy. […] Diversion proctitis. People who don’t have their rectum removed during ostomy surgery of the bowel may develop diversion proctitis, or inflammation in the remaining rectum. […] Other factors may cause proctitis. These include injury to the anus or rectum, side effects of medicines, such as nonsteroidal anti-inflammatory drugs (NSAIDs), and lack of blood flow to the rectum.

• #2 Proctitis – Causes, Symptoms and Treatment | Apollo Hospitals

  http://www.apollohospitals.com/diseases-and-conditions/proctitis

  Few broad-spectrum antibiotics used to treat infections can often kill harmful bacteria in the rectum. This in turn allows the growth of the bacteria, Clostridium difficile, in the rectum causing proctitis. […] Proctitis is often seen in people undergoing colon surgery where the passage of stool is diverted from the rectum to an opening that is created surgically. […] This type of proctitis occurs when eosinophils, which are a type of white blood cells, build up in the lining of the rectum. Eosinophilic proctitis is common in children younger than two years. […] This type of proctitis occurs in infants who drink either cows milk or soy-based formula. […] The disease is most commonly associated with sexually transmitted infections but can be caused by other factors as well.

• #2 Proctitis: What it is, Symptoms, Causes & Treatment

  https://my.clevelandclinic.org/health/diseases/5964-proctitis

  Radiation therapy for cancer can cause radiation mucositis anywhere in your gastrointestinal tract. […] Some less common causes of proctitis include: Diversion proctitis. This side effect can occur in people whove had a colostomy or ileostomy that diverted their poop away from their rectum. […] Eosinophilic gastrointestinal disorders (EGID). Eosinophilia is when your body produces an abnormally high number of white blood cells (eosinophils). […] Idiopathic proctitis. In a small percentage of people, no direct cause for proctitis can be found. However, these cases often respond to dietary changes.

• #2 Proctitis Causes, Symptoms and Treatment

  https://www.netmeds.com/health-library/post/proctitis-causes-symptoms-and-treatment?srsltid=AfmBOopmvIXO584ikeYI__dt-WvNec21uecT09hxTUbcGsxqJQxGrBHC

  Certain antibiotics used to treat an infection can actually kill the good bacteria in the bowels allowing the harmful ones such as Clostridium difficile bacteria to grow in the rectum causing inflammation and proctitis. […] An injury in the anal canal due to sexual activities, or excessive use of enemas can lead to this inflamed condition.

• #2 Proctitis: Symptoms, Causes, and Effective Treatment Options

  https://www.metropolisindia.com/blog/preventive-healthcare/proctitis-causes-symptoms-and-treatment-for-rectal-inflammation

  Some less common proctitis causes include: Anal Injuries: Injuries from anal sex or anal play may lead to inflammation and discomfort, potentially causing proctitis if the tissue is irritated or damaged. […] Medications: Certain medications, particularly NSAIDs, have been linked to proctitis as a side effect. In these cases, changing or stopping the medication under medical guidance may relieve symptoms. […] Insertion of Harmful Substances: The introduction of foreign or harmful substances into the rectum can damage tissues and lead to inflammation. […] Autoimmune Diseases: Other autoimmune conditions, like lupus, may cause autoimmune proctitis, where the immune system mistakenly attacks rectal tissue.

• #2 Proctitis – Sydney Colorectal Associates

  https://sydneycolorectal.com.au/conditions/proctitis/

  Proctitis is an inflammation of the rectum that causes bleeding, discomfort and sometimes a discharge of mucus or pus. […] Although there are a few known specific causes of proctitis, the common form is called Non Specific Proctitis and the cause is unknown. […] Irradiation proctitis tends to occur next to the organ that was irradiated, for example, the inflammation is close to the anus after prostate cancer irradiation and higher up after irradiation for cervical cancer. […] Infective proctitis may resolve spontaneously. Should a particular germ be isolated, a course of the appropriate antibiotics would be prescribed. […] It is very rare for other symptoms to occur with nonspecific proctitis.

• #2 Proctitis – UF Health

  https://ufhealth.org/conditions-and-treatments/proctitis

  Proctitis is an inflammation of the rectum. It can cause discomfort, bleeding, and the discharge of mucus or pus. […] There are many causes of proctitis. They can be grouped as follows: Inflammatory bowel disease, Autoimmune disease, Harmful substances, Non-sexually transmitted infection, Sexually transmitted disease (STD). […] Proctitis caused by an STD is common in people who have anal intercourse. STDs that can cause proctitis include gonorrhea, herpes, chlamydia, and lymphogranuloma venereum. […] Infections that are not sexually transmitted are less common than STD proctitis. One type of proctitis not from an STD is an infection in children that is caused by the same bacteria as strep throat. […] Autoimmune proctitis is linked to diseases such as ulcerative colitis or Crohn disease. If the inflammation is in the rectum only, it may come and go or move upward into the large intestine. […] Proctitis may also be caused by some medicines, radiotherapy to prostate or pelvis or inserting harmful substances into the rectum. […] Risk factors include: Autoimmune disorders, including inflammatory bowel disease, High-risk sexual practices, such as anal sex.

• #2 Proctitis | 5-Minute Clinical Consult

  https://www.unboundmedicine.com/5minute/view/5-Minute-Clinical-Consult/116488/all/Proctitis

  Acute or chronic inflammation of the rectal mucosa […] Chronic radiation proctitis secondary to ischemic and fibrotic changes […] DP: Proximal fecal diversion causes increased nitrate-reducing bacteria and decreased obligate anaerobes resulting in short-chain fatty acids (SCFAs) deficiency. […] Rectal intercourse in women or MSM can result in proctocolitis. […] Infectious causes: STIs: Gonorrhea; chlamydia; syphilis; Herpes simplex virus (HSV; 90% HSV-2); Lymphogranuloma venereum (LGV); chancroid; Cytomegalovirus (CMV); Human papillomavirus (HPV). […] Inflammatory causes: UC; Crohn disease. […] Other causes: Radiation injury occurs with doses 8 Gy or higher; Damage to intestinal cell DNA with helical breaks, inability to replicate and undergo normal cellular repair; Acute radiation injury usually occurs within 6 weeks of treatment. […] In genetically predisposed individuals with dysregulated immune responses, GI infections may increase the risk of UP.

• #2 Proctitis | Colorectal Surgeons Sydney

  http://colorectalsurgeonssydney.com.au/conditions/rectal-conditions/proctitis

  Other infectious causes of proctitis include those due to sexually transmitted diseases (STDs), such as gonorrhoea, chlamydia, and herpes simplex virus 1 and 2. […] Longstanding proctitis, particularly those caused by inflammatory bowel disease (IBD) are associated with an increased risk of cancer transformation. […] The progression from proctitis to cancer is over a period of time.

• #3 Proctitis – ADH North Shore

  https://northshoregastro.com/conditions-and-diseases/proctitis/

  Proctitis refers to an inflammation in the lining of the rectum (rectal mucosa), which can cause rectal pain and bleeding. Proctitis can be chronic, with long-term symptoms, or acute, with symptoms that last a short period of time. Some of the more common causes of proctitis include: […] Sexually transmitted diseases (STDs). This is one of the more common reasons proctitis can develop. Sexually transmitted diseases can be passed through anal sex, such as gonorrhea, chlamydia, syphilis, and herpes. These STDs can cause proctitis to occur. In patients with HIV and herpes, proctitis can be very severe. […] Other types of infection. Proctitis can occur from infections other than STDs. Foodborne bacteria, such as Salmonella and Shigella, can cause it, and Streptococcal proctitis can occur in children who have strep throat.

• #3 Ulcerative Colitis vs Proctitis: What’s the Difference?

  https://www.webmd.com/ibd-crohns-disease/ulcerative-colitis/ulcerative-colitis-vs-proctitis

  Proctitis can be its own condition when the cause is an infection or something else. Or it can be a form of ulcerative colitis that’s only in the rectum, which is called ulcerative proctitis and is the most common type of proctitis. About 30% of people with UC have ulcerative proctitis. In 27% to 54% of people who are diagnosed with ulcerative proctitis, the inflammation spreads up the colon and progresses to ulcerative colitis. […] The exact cause of ulcerative colitis is unknown, but it likely stems from a problem with the immune system. Normally, the immune system releases white blood cells and inflammatory chemicals to fight the germs that cause infections. One theory is that in UC, the immune system tries to attack a virus or bacteria in the intestine. Instead, it mistakenly attacks healthy cells, causing inflammation and sores called ulcers in the colon lining.

• #3 Proctitis treatment guidelines – Melbourne Sexual Health Centre (MSHC)

  https://www.mshc.org.au/health-professionals/treatment-guidelines/proctitis-treatment-guidelines

  Proctitis is the inflammation of the anal canal and distal rectum. Sexually acquired proctitis is commonly caused by: Chlamydia trachomatis (including LGV), Neisseria gonorrhoeae, Herpes simplex virus types 1 and 2 (HSV-1 and -2), Syphilis, Mpox. […] Proctocolitis can also be caused by enteric pathogens such as campylobacter, salmonella and shigella which are transmitted between men during oral to anal sexual contact. […] Non-infective causes of proctitis may include: inflammatory bowel disease (Ulcerative colitis or Crohn’s disease).

• #3 Symptoms & Causes of Proctitis – NIDDK

  https://www.niddk.nih.gov/health-information/digestive-diseases/proctitis/symptoms-causes

  Different types of proctitis have different causes. […] Proctitis of inflammatory bowel disease. Two types of inflammatory bowel disease ulcerative colitis and Crohns disease may cause proctitis. […] Infectious proctitis. Several sexually transmitted diseases (STDs) can infect the rectum and cause proctitis, including gonorrhea, chlamydia, genital herpes, and syphilis. […] Other infections in the rectum that can cause proctitis include infections that cause food poisoning, such as Salmonella, Shigella, and Campylobacter infections. […] Radiation proctitis or radiation proctopathy. Radiation therapy to treat cancer in your pelvic area or lower abdomen may cause radiation proctopathy. […] Diversion proctitis. People who don’t have their rectum removed during ostomy surgery of the bowel may develop diversion proctitis, or inflammation in the remaining rectum. […] Other factors may cause proctitis. These include injury to the anus or rectum, side effects of medicines, such as nonsteroidal anti-inflammatory drugs (NSAIDs), and lack of blood flow to the rectum.

• #3 Proctitis – Augusta HealthSearchClose SearchSearch IconSearch IconClose Search IconMobile Menu IconMobile Menu Close IconInstagramFacebookTwitterYoutube

  https://www.augustahealth.com/disease/proctitis/

  Radiation therapy for cancer. Radiation therapy directed at your rectum or nearby areas, such as the prostate, can cause rectal inflammation. Radiation proctitis can begin during radiation treatment and last for a few months after treatment. Or it can occur years after treatment. […] Antibiotics. Sometimes antibiotics used to treat an infection can kill helpful bacteria in the bowels, allowing the harmful Clostridium difficile bacteria to grow in the rectum. […] Diversion proctitis. Proctitis can occur in people following some types of colon surgery in which the passage of stool is diverted from the rectum to a surgically created opening (stoma). […] Food protein-induced proctitis. This can occur in infants who drink either cow’s milk- or soy-based formula. Infants breast-fed by mothers who eat dairy products also may develop proctitis. […] Eosinophilic proctitis. This condition occurs when a type of white blood cell (eosinophil) builds up in the lining of the rectum. Eosinophilic proctitis affects only children younger than 2.

• #3 Proctitis | 5-Minute Clinical Consult

  https://www.unboundmedicine.com/5minute/view/5-Minute-Clinical-Consult/116488/all/Proctitis

  Acute or chronic inflammation of the rectal mucosa […] Chronic radiation proctitis secondary to ischemic and fibrotic changes […] DP: Proximal fecal diversion causes increased nitrate-reducing bacteria and decreased obligate anaerobes resulting in short-chain fatty acids (SCFAs) deficiency. […] Rectal intercourse in women or MSM can result in proctocolitis. […] Infectious causes: STIs: Gonorrhea; chlamydia; syphilis; Herpes simplex virus (HSV; 90% HSV-2); Lymphogranuloma venereum (LGV); chancroid; Cytomegalovirus (CMV); Human papillomavirus (HPV). […] Inflammatory causes: UC; Crohn disease. […] Other causes: Radiation injury occurs with doses 8 Gy or higher; Damage to intestinal cell DNA with helical breaks, inability to replicate and undergo normal cellular repair; Acute radiation injury usually occurs within 6 weeks of treatment. […] In genetically predisposed individuals with dysregulated immune responses, GI infections may increase the risk of UP.

• #3 Proctitis – Causes, Symptoms and Treatment | Apollo Hospitals

  http://www.apollohospitals.com/diseases-and-conditions/proctitis

  Few broad-spectrum antibiotics used to treat infections can often kill harmful bacteria in the rectum. This in turn allows the growth of the bacteria, Clostridium difficile, in the rectum causing proctitis. […] Proctitis is often seen in people undergoing colon surgery where the passage of stool is diverted from the rectum to an opening that is created surgically. […] This type of proctitis occurs when eosinophils, which are a type of white blood cells, build up in the lining of the rectum. Eosinophilic proctitis is common in children younger than two years. […] This type of proctitis occurs in infants who drink either cows milk or soy-based formula. […] The disease is most commonly associated with sexually transmitted infections but can be caused by other factors as well.

• #3 Proctitis | Altru Health System

  https://www.altru.org/health-library/conditions/proctitis

  Diversion proctitis. Proctitis can occur in people following some types of colon surgery in which the passage of stool is diverted from the rectum to a surgically created opening (stoma). […] Food protein-induced proctitis. This can occur in infants who drink either cow’s milk- or soy-based formula. […] Eosinophilic proctitis. This condition occurs when a type of white blood cell (eosinophil) builds up in the lining of the rectum.

• #3 Radiation Proctitis | Saint Luke’s Health System

  https://www.saintlukeskc.org/health-library/radiation-proctitis

  Proctitis can be caused by many things. […] Radiation proctitis occurs from having radiation treatment for cancer in the pelvic area. […] This condition is caused by radiation therapy to treat cancer in the rectum or the areas around it. […] Youre at risk for this condition if youve had radiation therapy on your rectum or on areas around it. […] People who receive a higher dose or certain types of radiation are at greater risk for radiation proctitis.

• #3 Ulcerative Proctitis Vs Colitis: Symptoms, Causes, And Key Differences

  https://colorectalsurgery.com.sg/ulcerative-proctitis-vs-colitis/

  Smoking is associated with an increased risk of UC development, but paradoxically, it may have a protective effect against UP (ulcerative proctitis). However, the reasons for this difference are not fully understood, and the overall health risks associated with smoking outweigh any potential benefits related to UC.

• #4 Proctitis – ADH North Shore

  https://northshoregastro.com/conditions-and-diseases/proctitis/

  Antibiotics. While antibiotics are designed to kill off “bad bacteria,” sometimes they can kill good bacteria as well. When this happens, bacteria such as Clostridium difficile can form, causing the condition. […] Anorectal trauma. Anal sex or objects inserted into the anus can cause rectal irritation. […] Inflammatory bowel disease (IBD). Patients with an IBD diagnosis, such as ulcerative colitis (UC) or Crohn’s disease, are susceptible to proctitis. UC occurs only in the colon and rectal area, while Crohn’s disease can flare up anywhere on the digestive tract. […] Radiation. Patients who have received radiation in the pelvic region are more prone to developing proctitis.

• #4 Acute Proctitis: Background, Pathophysiology, Etiology

  https://emedicine.medscape.com/article/775952-overview

  Proctitis has many causes. It may be a side effect of medical treatments like radiation therapy or antibiotics. Proctitis caused by sexually transmitted diseases (STDs) is transmitted through receptive anal intercourse and is most commonly due to gonorrhea and chlamydia, or less commonly lymphogranuloma venereum or herpes virus. Nonsexually transmitted causes include autoimmune disease of the colon, such as Crohn disease and ulcerative colitis, celiac disease, chemicals, rectal instrumentation, and trauma to the anorectal area. It may also occur as idiopathic proctitis. […] Causes of proctitis may include the following: N gonorrhoeae, C trachomatis, HSV 1 (10%) and HSV 2 (90%), Radiation therapy, Immunodeficiency disorders, Crohn disease, Syphilis (usually secondary), Papillomavirus, Amebiasis, Lymphogranuloma venereum, Ischemia, Toxins (eg, hydrogen peroxide enemas), Vasculitis, Cytomegalovirus (CMV), Clostridium difficile, Campylobacter species.

• #4 Proctitis – Augusta HealthSearchClose SearchSearch IconSearch IconClose Search IconMobile Menu IconMobile Menu Close IconInstagramFacebookTwitterYoutube

  https://www.augustahealth.com/disease/proctitis/

  Radiation therapy for cancer. Radiation therapy directed at your rectum or nearby areas, such as the prostate, can cause rectal inflammation. Radiation proctitis can begin during radiation treatment and last for a few months after treatment. Or it can occur years after treatment. […] Antibiotics. Sometimes antibiotics used to treat an infection can kill helpful bacteria in the bowels, allowing the harmful Clostridium difficile bacteria to grow in the rectum. […] Diversion proctitis. Proctitis can occur in people following some types of colon surgery in which the passage of stool is diverted from the rectum to a surgically created opening (stoma). […] Food protein-induced proctitis. This can occur in infants who drink either cow’s milk- or soy-based formula. Infants breast-fed by mothers who eat dairy products also may develop proctitis. […] Eosinophilic proctitis. This condition occurs when a type of white blood cell (eosinophil) builds up in the lining of the rectum. Eosinophilic proctitis affects only children younger than 2.

• #4 Radiation Proctitis: Causes, Symptoms & Treatment

  https://my.clevelandclinic.org/health/diseases/radiation-proctitis

  Radiation proctitis may develop as a complication of radiation therapy in your pelvic area. […] Late radiation proctitis usually develops because radiation therapy causes: Scar-like tissue to build up in your rectum or the surrounding tissues (fibrosis), Wide blood vessels (telangiectasia), Narrow arterioles.

• #4 Proctitis – Digestive Disorders – Merck Manual Consumer Version

  https://www.merckmanuals.com/home/digestive-disorders/anal-and-rectal-disorders/proctitis

  Proctitis has several causes. […] The inflammation has many causes ranging from infection to radiation therapy. […] It may result from Crohn disease or ulcerative colitis. It can also result from a sexually transmitted infection (such as gonorrhea, syphilis, Chlamydia trachomatis infection, herpes simplex virus infection, or Mpox infection), especially among people who engage in anal-receptive intercourse. […] Proctitis may also be caused by some bacteria not transmitted sexually, such as Salmonella, or by the use of an antibiotic that destroys normal intestinal bacteria, thus allowing other bacteria to grow in their place (Clostridioides difficile). […] A person whose immune system is impaired is also at increased risk of developing proctitis, particularly from infections by herpes simplex virus or cytomegalovirus. […] Another cause of proctitis is radiation therapy directed at or near the rectum, which is commonly used to treat prostate and rectal cancer.

• #5 Ulcerative Colitis and Proctitis – Gastroenterologist

  https://www.bonheurmd.com/ulcerative-colitis-and-proctitis/

  We do not yet know what causes this disease. Studies indicate that the inflammation in ulcerative colitis involves a complex interaction of factors: the genes the person has inherited, the immune system, and something in the environment. Foreign substances (antigens) in the environment may be the direct cause of the inflammation, or they may stimulate the body’s defenses to produce an inflammation that continues without control. […] In patients with ulcerative colitis, once the patient’s immune system is turned on, it does not know how to properly turn off. As a result, inflammation damages the intestine and causes the symptoms of ulcerative colitis.

• #5 Acute Proctitis: Background, Pathophysiology, Etiology

  https://emedicine.medscape.com/article/775952-overview

  Proctitis has many causes. It may be a side effect of medical treatments like radiation therapy or antibiotics. Proctitis caused by sexually transmitted diseases (STDs) is transmitted through receptive anal intercourse and is most commonly due to gonorrhea and chlamydia, or less commonly lymphogranuloma venereum or herpes virus. Nonsexually transmitted causes include autoimmune disease of the colon, such as Crohn disease and ulcerative colitis, celiac disease, chemicals, rectal instrumentation, and trauma to the anorectal area. It may also occur as idiopathic proctitis. […] Causes of proctitis may include the following: N gonorrhoeae, C trachomatis, HSV 1 (10%) and HSV 2 (90%), Radiation therapy, Immunodeficiency disorders, Crohn disease, Syphilis (usually secondary), Papillomavirus, Amebiasis, Lymphogranuloma venereum, Ischemia, Toxins (eg, hydrogen peroxide enemas), Vasculitis, Cytomegalovirus (CMV), Clostridium difficile, Campylobacter species.

• #5 Proctitis | 5-Minute Clinical Consult

  https://www.unboundmedicine.com/5minute/view/5-Minute-Clinical-Consult/116488/all/Proctitis

  Acute or chronic inflammation of the rectal mucosa […] Chronic radiation proctitis secondary to ischemic and fibrotic changes […] DP: Proximal fecal diversion causes increased nitrate-reducing bacteria and decreased obligate anaerobes resulting in short-chain fatty acids (SCFAs) deficiency. […] Rectal intercourse in women or MSM can result in proctocolitis. […] Infectious causes: STIs: Gonorrhea; chlamydia; syphilis; Herpes simplex virus (HSV; 90% HSV-2); Lymphogranuloma venereum (LGV); chancroid; Cytomegalovirus (CMV); Human papillomavirus (HPV). […] Inflammatory causes: UC; Crohn disease. […] Other causes: Radiation injury occurs with doses 8 Gy or higher; Damage to intestinal cell DNA with helical breaks, inability to replicate and undergo normal cellular repair; Acute radiation injury usually occurs within 6 weeks of treatment. […] In genetically predisposed individuals with dysregulated immune responses, GI infections may increase the risk of UP.

• #5 Infectious Proctitis: Causes And Treatment – Klarity Health Library

  https://my.klarity.health/infectious-proctitis-causes-and-treatment/

  Infectious Proctitis is an infection where it causes inflammation (swelling) in your bowels and rectum, and it can be procured through a sexually transmitted infection (STI). […] Inflammation in the rectum can be caused by bacteria, chemicals or even by inflammatory bowel disease. The other cause is STI, which includes gonorrhoea, genital herpes, and chlamydia. […] As per reports, there has been an increase in patients with this infection seen by gastroenterologists because of an increase in anal exposure. This is reasoned by homosexual intimacy in people AMAB, as well as patients with existing HIV. […] A comprehensive assessment is needed for an efficient therapeutic approach.

• #6 Ulcerative Proctitis Symptoms, Diagnosis, Treatment | SELF

  https://www.self.com/story/ulcerative-proctitis

  Ulcerative proctitis is thought to be an over-activation of the immune system, although experts still don’t know why this happens in certain people and not others, Robert Lerrigo, M.D., associate chief of gastroenterology and hepatology at Santa Clara Valley Medical Center, tells SELF. […] The general thinking is that in all forms of inflammatory bowel disease, the immune system is dysregulated. […] There may be a genetic component behind the condition. Having a family history of any type of IBD makes it more likely that you’ll develop this wonky immune response in the GI tract, according to the Centers for Disease Control and Prevention (CDC).

• #6 Separating Infectious Proctitis from Inflammatory Bowel Disease—A Common Clinical Conundrum

  https://www.mdpi.com/2076-2607/12/12/2395

  Proctitis refers to inflammation in the rectum and may result in rectal bleeding, discharge, urgency, tenesmus, and lower abdominal pain. […] The two most common causes of patients presenting with proctitis are infective causes and inflammatory bowel disease (IBD). […] Infective proctitis is usually caused by sexually transmitted infections. […] The most commonly isolated organisms causing infective proctitis are Neisseria gonorrhoeae, Chlamydia trachomatis, and Treponema pallidum. […] Infective proctitis predominately occurs in patients with a history of receptive anal sex leading to direct inoculation. […] Other risk factors for the development of infective proctitis include HIV seropositive status, sexually transmitted infections in the previous six months, unprotected receptive anal intercourse, and traumatic sex.

• #6 Proctitis – ADH North Shore

  https://northshoregastro.com/conditions-and-diseases/proctitis/

  Proctitis refers to an inflammation in the lining of the rectum (rectal mucosa), which can cause rectal pain and bleeding. Proctitis can be chronic, with long-term symptoms, or acute, with symptoms that last a short period of time. Some of the more common causes of proctitis include: […] Sexually transmitted diseases (STDs). This is one of the more common reasons proctitis can develop. Sexually transmitted diseases can be passed through anal sex, such as gonorrhea, chlamydia, syphilis, and herpes. These STDs can cause proctitis to occur. In patients with HIV and herpes, proctitis can be very severe. […] Other types of infection. Proctitis can occur from infections other than STDs. Foodborne bacteria, such as Salmonella and Shigella, can cause it, and Streptococcal proctitis can occur in children who have strep throat.

• #6 Proctitis | Colon & Rectal Surgical Specialists

  https://www.crssny.com/conditions/proctitis/

  Proctitis is often the result of an underlying medical condition, such as: […] You may be at risk for developing proctitis if you participate in unsafe sex, have been diagnosed with a type of inflammatory disease, such as Crohns disease or ulcerative colitis, or are currently undergoing radiation therapy near your rectum to treat cancer. Prolonged use of antibiotics can also increase your risk for proctitis. […] The first step to addressing proctitis is diagnosing the cause in order to reduce inflammation and adequately treat the infection.

• #7 Ulcerative Proctitis: Symptoms, Causes, Diagnosis, Treatment

  https://www.verywellhealth.com/ulcerative-proctitis-overview-5211448

  Ulcerative proctitis is a condition that affects the rectum. […] The cause of ulcerative proctitis (like ulcerative colitis or IBD in general) is not known. There are several theories. […] The various forms of IBD, including ulcerative proctitis, are thought to be immune-mediated conditions. There is a problem with the immune system that causes it to attack the healthy tissue in the digestive system. […] Over 100 genes have been found that are thought to contribute to the development of IBD. But it is not only the genetics that leads to ulcerative proctitis. […] Its thought that there must also be something else that occurs, one or more environmental triggers. This is something that causes a disruption in the balance of the bacteria that naturally live in the colon. This may lead to the lining of the intestine becoming ulcerated.

• #7 Separating Infectious Proctitis from Inflammatory Bowel Disease—A Common Clinical Conundrum

  https://www.mdpi.com/2076-2607/12/12/2395

  Proctitis refers to inflammation in the rectum and may result in rectal bleeding, discharge, urgency, tenesmus, and lower abdominal pain. […] The two most common causes of patients presenting with proctitis are infective causes and inflammatory bowel disease (IBD). […] Infective proctitis is usually caused by sexually transmitted infections. […] The most commonly isolated organisms causing infective proctitis are Neisseria gonorrhoeae, Chlamydia trachomatis, and Treponema pallidum. […] Infective proctitis predominately occurs in patients with a history of receptive anal sex leading to direct inoculation. […] Other risk factors for the development of infective proctitis include HIV seropositive status, sexually transmitted infections in the previous six months, unprotected receptive anal intercourse, and traumatic sex.

• #7 Proctitis treatment guidelines – Melbourne Sexual Health Centre (MSHC)

  https://www.mshc.org.au/health-professionals/treatment-guidelines/proctitis-treatment-guidelines

  Proctitis is the inflammation of the anal canal and distal rectum. Sexually acquired proctitis is commonly caused by: Chlamydia trachomatis (including LGV), Neisseria gonorrhoeae, Herpes simplex virus types 1 and 2 (HSV-1 and -2), Syphilis, Mpox. […] Proctocolitis can also be caused by enteric pathogens such as campylobacter, salmonella and shigella which are transmitted between men during oral to anal sexual contact. […] Non-infective causes of proctitis may include: inflammatory bowel disease (Ulcerative colitis or Crohn’s disease).

• #7 Proctitis and Anusitis – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK430892/

  Proctitis and anusitis may happen secondary to ulcerative colitis (UC), Chronic Radiation Proctitis, Proctopathy (CRP), or Diversion Proctitis (DP). Infectious causes include Clostridium difficile, enteric infections (Campylobacter, Shigella, Escherichia coli, Salmonella, and amebiasis), and STIs (Gonorrhea, Chlamydia, Syphilis, HSV, Lymphogranuloma venereum, chancroid, CMV, HPV). […] Other causes include ischemia, vasculitis, toxins as hydrogen peroxide enemas or medication side effects. The most common cause of anusitis is diet, as with excess citrus, coffee, cola, beer, garlic, spices, and sauces. Diarrhea noted after intake of laxatives as in preparation for colonoscopy is noted to cause anusitis and stress may be another etiologic factor.

• #8 Infectious Proctitis: Causes And Treatment – Klarity Health Library

  https://my.klarity.health/infectious-proctitis-causes-and-treatment/

  Infectious Proctitis is an infection where it causes inflammation (swelling) in your bowels and rectum, and it can be procured through a sexually transmitted infection (STI). […] Inflammation in the rectum can be caused by bacteria, chemicals or even by inflammatory bowel disease. The other cause is STI, which includes gonorrhoea, genital herpes, and chlamydia. […] As per reports, there has been an increase in patients with this infection seen by gastroenterologists because of an increase in anal exposure. This is reasoned by homosexual intimacy in people AMAB, as well as patients with existing HIV. […] A comprehensive assessment is needed for an efficient therapeutic approach.

• #8 Proctitis | Dr Melissa White | Sunshine Coast Gastroenterologist

  https://www.melissawhitegastro.com.au/articles/proctitis

  Proctitis is commonly caused by auto-immune diseases of the colon (such as Crohns disease and Ulcerative Colitis), harmful physical agents, chemicals, foreign objects placed in the rectum, trauma to the anorectal area and sexually transmitted infections. […] More rare causes include damage by irradiation (e.g. cervical and prostate cancer radiation therapy) or a sexually transmitted infection such as lympogranuloma venereum and herpes Proctitis. […] Proctitis is also linked to stress.

• #9 Proctitis and Anusitis – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK430892/

  Proctitis and anusitis may happen secondary to ulcerative colitis (UC), Chronic Radiation Proctitis, Proctopathy (CRP), or Diversion Proctitis (DP). Infectious causes include Clostridium difficile, enteric infections (Campylobacter, Shigella, Escherichia coli, Salmonella, and amebiasis), and STIs (Gonorrhea, Chlamydia, Syphilis, HSV, Lymphogranuloma venereum, chancroid, CMV, HPV). […] Other causes include ischemia, vasculitis, toxins as hydrogen peroxide enemas or medication side effects. The most common cause of anusitis is diet, as with excess citrus, coffee, cola, beer, garlic, spices, and sauces. Diarrhea noted after intake of laxatives as in preparation for colonoscopy is noted to cause anusitis and stress may be another etiologic factor.

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