Thickening of the rectal wall

Hello. First I will provide some background information. I am a 38 year old female.  Last Sept. 07 I was having very loose stools and a feeling of having to have a bowel movement, but not actually having one. I went to see a GI doctor and he performed a sigmoidoscopy. The sigmoid was completely clear and he had me modifly my diet. The feeling of needing to have a bowel movement lasted for only a few days and went away completely. The loose stools have continued, but are not bothersome. I still only go once a day, usually in the morning with the loose stool that contains some mucous. Within the last month I have had a few incidents of more formed stools that are harder to pass. I also have had some lower back pain on the right side (just above the buttocks). My PCP sent me for an abdominal/pelvic cat scan (with and without contrast). The results are as follows:

Impression:
1. Thickening of the rectal wall, nonspecific in appearance. The prossibility of proctitis must be considered. Direct examination may be appropriate.
2. Some free fluid in the pelvis
Otherwise everthing else was normal.

Here are my questions.
1. How accurate is a cat scan at detecting proctitis?
2. Could the proctitis have developed since last year when sigmoid was performed?
3. Do you think I should be worried about cancer and can cancer have developed from nothing to this that quickly?
4. Could this thickening of the rectal wall be causing my back pain and if so what is the most likely cause?
5. Is the pelvic fluid related to the rectal wall thickening or is this a normal finding?
Thank you.

[Ratnakar Kini, MD]

Hi,
The answer to your questions -

1. Proctitis produce thickening of the rectal wall and CT scan is the best imaging method to assess this.

2. Proctitis cause painful and ineffective evacuation of bowel.May be you had intermittent symptoms.

3. Biospy would be helpful.

4. There are a number of  conditions which can cause rectal wall thickening. Some of these can cause back ache.

5. Some amount of fluid in the pelvis is a normal finding.
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The information provided is for patients’ education only and is not a medical advice. Always consult your personal physician for complete evaluation of your health problem.

- Ratnakar Kini M.D.