{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,22]],"date-time":"2026-04-22T01:46:20Z","timestamp":1776822380396,"version":"3.51.2"},"reference-count":145,"publisher":"MDPI AG","issue":"12","license":[{"start":{"date-parts":[[2024,11,22]],"date-time":"2024-11-22T00:00:00Z","timestamp":1732233600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Microorganisms"],"abstract":"<jats:p>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.<\/jats:p>","DOI":"10.3390\/microorganisms12122395","type":"journal-article","created":{"date-parts":[[2024,11,22]],"date-time":"2024-11-22T06:41:48Z","timestamp":1732257708000},"page":"2395","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Separating Infectious Proctitis from Inflammatory Bowel Disease\u2014A Common Clinical Conundrum"],"prefix":"10.3390","volume":"12","author":[{"given":"Richard","family":"Hall","sequence":"first","affiliation":[{"name":"Department of Gastroenterology, St George\u2019s University Hospital, London SW17 0QT, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kamal","family":"Patel","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, St George\u2019s University Hospital, London SW17 0QT, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0703-0328","authenticated-orcid":false,"given":"Andrew","family":"Poullis","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, St George\u2019s University Hospital, London SW17 0QT, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6452-6763","authenticated-orcid":false,"given":"Richard","family":"Pollok","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, St George\u2019s University Hospital, London SW17 0QT, UK"},{"name":"Institute of Infection and Immunity, St George\u2019s University, London SW17 0RE, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sailish","family":"Honap","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, St George\u2019s University Hospital, London SW17 0QT, UK"},{"name":"School of Immunology and Microbial Sciences, King\u2019s College London, London SE1 9NH, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2024,11,22]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1434","DOI":"10.1111\/jdv.17269","article-title":"2021 European Guideline on the Management of Proctitis, Proctocolitis and Enteritis Caused by Sexually Transmissible Pathogens","volume":"35","author":"Nori","year":"2021","journal-title":"J. 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