STD and Proctitis, Proctocolitis, Enteritis

Sign and Symptom (could have one or more of following signs)

* Diarrhea

* Abdominal Pain, Cramp

* Rectal Discharge

* Rectal, Anal Pain, tinsmus (feeling of incomplete defecation)

Proctitis:

Proctitis is inflammation of the rectum (i.e., the distal 10–12 cm) that might be associated with anorectal pain, tenesmus (feeling of incomplete defecation) , or rectal discharge. N. gonorrhea, C. trachomatis (including LGV serovars), T. pallidum, and HSV are the most common sexually transmitted pathogens involved. In patients coinfected with HIV, herpes proctitis might be especially severe. Proctitis occurs predominantly among persons who participate in receptive anal intercourse.

Proctocolitis

Proctocolitis is associated with symptoms of proctitis and diarrhea or abdominal cramps and inflammation of the colonic mucosa, extending to 12 cm above the anus. Fecal leukocytes might be detected on stool examination, depending on the pathogen. Pathogenic organisms include Campylobacter sp., Shigella sp., Entamoeba histolytica, and, rarely, LGV serovars of C. trachomatis. CMV or other opportunistic agents might be involved in immunosuppressed HIV-infected patients. Proctocolitis can be acquired by the oral route or by oral-anal contact, depending on the pathogen.

Enteritis

Enteritis usually results in diarrhea and abdominal cramping without signs of proctitis or proctocolitis; it occurs among persons whose sexual practices include oral-anal contact. In otherwise healthy persons, Giardia lamblia is most frequently implicated. When outbreaks of gastrointestinal illness occur among social or sexual networks of MSM, clinicians should consider sexual transmission as a mode of spread and provide counseling accordingly. Among HIV-infected patients, gastrointestinal illness can be caused by other infections that usually are not sexually transmitted, including CMV, Mycobacterium avium-intracellulare, Salmonella sp., Campylobacter sp., Shigella sp., Cryptosporidium, Microsporidium, and Isospora. Multiple stool examinations might be necessary to detect Giardia, and special stool preparations are required to diagnose cryptosporidiosis and microsporidiosis. In addition, enteritis might be directly caused by HIV infection.

When laboratory diagnostic capabilities are

Shigella

It is a bacterial infection which cause abdominal pain, cramp and diarrhea.

Shigella is the third most common cause of bacterial gastroenteritis in the United States . There has been recent an increase in Shigella infection among adult males. This increase is likely attributable to outbreaks of shigellosis among MSM (male having sex with male) ; since the 1970s, outbreaks of shigellosis attributable to Shigella. flexneri and more recently Shigella. sonnei have been reported among MSM in major cities in North America.

Shigella could get transmitted from person to other person with oral- anal contact. This could be possibly part of sexual activity and contact. If oral sex is involve leaking and kissing contaminated genital skin such as penile or scrotum with contamination with shigella bacteria then this still could infect the sexual partner. Because Shigella and other enteric pathogens can be carried symptomatically, persons who engage in sexual contact that could expose them or their sex partners to fecal material should wash their hands and anal-genital regions thoroughly with soap and water before and after sexual activity.

How To Decrease the Chance of Transmission / Infection

Use Condom properly, use dental dams, rubber dams for oral sex. Wash your hands and your anal-genital area with soap and water before and after sex.

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