Pain in the Ass - Dr. Dick

Pain in the Ass

Dear Dr. Dick,
My new man and I made an adult decision to get tested together. First, we both tested positive for the clap. He also wanted to check on an issue he'd been having back there (blood and mucus when he went #2). Turns out he has proctitis! We both took antibiotics for the chlamydia....and the doc said the pills should also help his proctitis clear up. This is the first I've ever heard about proctitis. Doc, can you give me some mo' info pretty please?

Dear Guy,

Sorry to hear about your boo. Proctitis is the shits! In a nutshell, Proctitis means "inflammation of the rectum." Proctitis is a GI (gastrointestinal) syndrome that can cause the following symptoms:
• Pain in the anus and/or rectum (ouch!)
• Tenesmus (a painful feeling of needing to poop, even if your bowel is cleaned out)
• Discharge and/or bleeding from the rectum
• Diarrhea
• Pain when pooping
• Anal itching

Among MSM (Men who have Sex with Men), some of the common causes of proctitis are:
• STDs like gonorrhea, chlamydia, LGV (Lymphogranuloma Venereum), syphilis and genital herpes
• Shigella (check out my article on shigella for more info)
• Inserting harmful substances into the rectum, including some types of enemas

Other causes of proctitis can include:
• Bowel problems like IBS (Irritable Bowel Syndrome), Crohn's disease, and ulcerative colitis
• Some medications
• Radiation treatment for cancer
• Infections like salmonella

Symptoms of proctitis can be mistaken for other illnesses. If you have symptoms of proctitis, it's recommended that you see your medical provider. They may want you to have one or more of the following tests:
• Stool sample (testing your poop for disease-causing bacteria)
• Proctoscopy (carefully inserting a scope in your butt to examine your rectum)
• Rectal culture (carefully inserting a cotton swab in your butt to collect cells from the rectum. The sample is analyzed in a lab to check for bacteria and germs that could be causing proctitis)
• Sigmoidoscopy (a scope with a camera at its end is gently inserted into the anus, and then moved through the rectum and lower colon to examine the tissue)

The goal of treatment for proctitis is to reduce inflammation and symptoms, and to get rid of infection (if an infection is causing the proctitis!). Proctitis usually goes away when the cause of the problem goes away. Medication is prescribed based on the type of infection you have. If an STD like chlamydia or gonorrhea is causing the problem, treating the STD with antibiotics will usually clear the proctitis. If a viral STD is causing the problem, antivirals may be prescribed to help reduce proctitis symptoms. In addition, medicines to reduce inflammation may be provided in the form of creams, suppositories, or enemas.

• Avoid having sex until the proctitis symptoms go away
• If you have proctitis due to an STD, make sure that you and your partner(s) get treated before having sex again. If you do have sex while getting treated for STDs, use condoms to reduce the risk of re-infection.

• Condoms can help prevent proctitis, because they can prevent the spread of STDs
• The lining of the anus and rectum are delicate. Prolonged, rough crystal sex can cause trauma to this area. If you develop proctitis due to rough anal sex, consider "easing up" until your symptoms improve
• Good quality lube can help prevent friction and trauma to your anus. Check out my article Well-Oiled Machine for lube safety tips

In good health,

Dr. Dick

« Gonorrhea with the wind | Dr. Dick Home | Meds or No Meds? »