Archive for March 27th, 2009


Friday, March 27th, 2009

incidence: common

cause: bacteria, viruses, protozoa; varies depending on the location of the infection

symptoms: rectal pain, discharge, diarrhea

treatment: directed at the underlying cause

WHAT ARE THEY? Proctocolitis, proctitis, and enteritis are intestinal syndromes caused by infection with bacteria, viruses, or protozoa that can be transmitted sexually as well as by nonsexual means. Proctocolitis is an infection and inflammation of the rectum as well as the colon. It is usually caused by shigella, salmonella, Campylobacter, Entamoeba histolytica, ox lymphogranuloma venereum (LGV) infections. Proctitis is an infection and inflammation of the rectum, lower than in proctocolitis, which is usually caused by gonorrhea, chlamydia, herpes, or syphilis. Enteritis is an infection and inflammation of the small intestine, which is usually caused by giardia or hepatitis A. In persons with human immunodeficiency virus (HIV) infection, enteritis may also be caused by cytomegalovirus Mycobacterium avium complex, isospora, salmonella infections.



Friday, March 27th, 2009

Finding that may hold promise for couples trying to prevent herpes transmission is that people with herpes who take antiherpes medications (acyclovir, famciclovir, valacyclovir) on a regular basis (or suppressivefy; see later discussion) have fewer outbreaks. In addition, there is evidence that the level of shedding of the virus is significantly lower when people take acyclovir on a suppressive basis. Studies are investigating whether the newer medications also suppress shedding of the virus. People taking these medications may have a lower likelihood of transmitting herpes to their partners, and studies are also under way to see if this is true. If so, these medications may provide an option for couples who want to do something more to prevent transmission.

Extensive research is being performed to find a vaccine to prevent people from ever becoming infected with herpes viruses. If it is proven effective, a herpes vaccine could join the already available hepatitis A and B vaccines in the prevention of sexually transmitted infection.



Friday, March 27th, 2009

It is not clear where yeast comes from or how people become infected. What we do know is that fungal infections are not sexually transmitted, because those who are not sexually active can contract fungal infections of the genital area—although, as noted earlier, people who are sexually active seem to get them more frequently. We also know that the bacterium normally found in the vagina, Lactobacillus, offers women protection from yeast infections, because when the relative population size of this bacterium is disturbed yeast infection is more likely. And we know that treating the sexual partners of someone who has a yeast infection does not help the person with the infection.

Women who have sex only with women may pass yeast back and forth through the use of sex toys, although there is no scientific evidence for this theory. It has also been suggested that yeast colonization occurs in the gastrointestinal tract in most people and that reinfection of the genital area occurs from this source. However, studies have produced conflicting results: some women with recurrent vaginal yeast infections do not appear to have yeast colonization in the gastrointestinal tract, and treatment of gastrointestinal yeast has not affected the recurrence rate of vaginal yeast infections.



Friday, March 27th, 2009

ost people are aware that having unprotected sex with a partner carries a risk for infection with human immunodeficiency virus (HIV) and other sexually transmitted diseases. Nevertheless, twelve million people in the United States are infected with an STD each year. Why is this? Are they misinformed about STDs and how they are spread? Do they think they are not in a risk group? Do they deny the risk in the heat of the moment? Do they not understand what “safe sex” is and what it isn’t? All of these reasons and more explain why there is an epidemic of STDs in this country even in an age of increased media attention to the problem.

Eighty-five percent of people diagnosed with a sexually transmitted infection are between the ages of fifteen and thirty. Since adolescence is a time when experimentation with sexuality begins, teenagers don’t have much chance of avoiding infection with an STD unless someone talks with them clearly and accurately about sexually transmitted infections and about exactly how to have safe sex. As earlier discussions in this book have made clear, the health and other consequences of STDs range from minor nuisances to major threats, even death. To protect yourself from infection is the first step. Acting on that understanding by only having sex that is safe is an investment in your future health, your ability to have children, your relationships, perhaps your livelihood, and even your life.

First a word of caution about what follows. Some of it may be overwhelming. As I have said before in this book, having sex always involves some risk, if not for a sexually transmitted infection, then an emotional risk. But it would be absurd to suggest that people should avoid sex altogether, for it is a natural part of life for most people. Rather my intent is to teach those who are sexually active how to recognize the symptoms if they have an STD, how to obtain appropriate testing and treatment to maintain sexual health , how to communicate about sex in a way that will help protect them from getting an STD, and, in this chapter, how to practice safe sex (or “safer sex,” as it is often called—which really means, things people can do to lower their risk of acquiring an STD.



Friday, March 27th, 2009

This is the part of the physical men would rather do without. It’s uncomfortable, but it doesn’t hurt, is generally brief, and it can provide essential information that simply can’t be gotten any other way. You may be asked to stand next to the examining table and bend forward slightly, or your doctor may prefer that you kneel on the table or lie on your side. Note: If what you’re feeling goes beyond the obvious discomfort of having someone’s finger in your rectum and is clearly pain, this could be an important signal of another problem, such as prostatitis. If the exam is painful, tell your doctor.

Many men dread having this test for another reason—their doctor’s bedside manner, or lack thereof. Some men even put off going to the doctor because they don’t want to deal with someone who is rude, gruff, disrespectful, uncommunicative, or generally unpleasant, and this is a terrible shame. Good doctors know how to make their patients feel at ease. They talk to their patients, and treat them with respect. If your doctor’s unfortunate bedside manner is keeping you away from this or any other exam, find another doctor. There are plenty of good ones out there. It’s your money—and more importantly, it’s your health!