Clin Colon Rectal Surg 2015; 28(02): 070-078
DOI: 10.1055/s-0035-1547334
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Sexually Transmitted Proctitis

Gavin W. Sigle
1   Section of Colon and Rectal Surgery, MedStar Washington Hospital Center, Washington, District of Columbia
2   Department of Surgery, Georgetown University School of Medicine, Washington, District of Columbia
Rebekah Kim
3   Department of Colorectal Surgery, Virginia Hospital Center, Arlington, Virginia
› Author Affiliations
Further Information

Publication History

Publication Date:
25 May 2015 (online)


There are many different sexually transmitted infections that can cause proctitis. Recognition of the common symptoms with anoscopic examination is crucial in accurate diagnosis of the pathogen. Clinicians should have a high index of suspicion of more than one inciting pathogen. Treatment should be prompt and extended to sexual partners who have been exposed to the disease. Effective treatment can alleviate the discomfort and potentially serious complications associated with sexually transmitted proctitides. This article illustrates and discusses the clinical presentations, diagnostic pearls, and treatments of sexually transmitted proctitides.

  • References

  • 1 Davis TW, Goldstone SE. Sexually transmitted infections as a cause of proctitis in men who have sex with men. Dis Colon Rectum 2009; 52 (3) 507-512
  • 2 Puy-Montbrun T, Ganansia R, Lemarchand N, Delechenault P, Denis J. Anal ulcerations due to cytomegalovirus in patients with AIDS. Report of six cases. Dis Colon Rectum 1990; 33 (12) 1041-1043
  • 3 Centers for Disease Control and Prevention. Sexually Transmitted Disease Surveillance 2012. Atlanta: U.S. Department of Health and Human Services; 2013
  • 4 Workowski KA, Berman S ; Centers for Disease Control and Prevention (CDC). Sexually transmitted diseases treatment guidelines, 2010. MMWR Recomm Rep 2010; 59 (RR-12): 1-110
  • 5 Deheragoda P. Diagnosis of rectal gonorrhoea by blind anorectal swabs compared with direct vision swabs taken via a proctoscope. Br J Vener Dis 1977; 53 (5) 311-313
  • 6 Centers for Disease Control and Prevention (CDC). Update to CDC's sexually transmitted diseases treatment guidelines, 2006: fluoroquinolones no longer recommended for treatment of gonococcal infections. MMWR Morb Mortal Wkly Rep 2007; 56 (14) 332-336
  • 7 Geisler WM, Whittington WL, Suchland RJ, Stamm WE. Epidemiology of anorectal chlamydial and gonococcal infections among men having sex with men in Seattle: utilizing serovar and auxotype strain typing. Sex Transm Dis 2002; 29 (4) 189-195
  • 8 O'Farrell N. Donovanosis. Sex Transm Infect 2002; 78 (6) 452-457
  • 9 Maron D. Sexually Transmitted Diseases. American Society of Colon and Rectal Surgeons; 2011 Core Subjects.
  • 10 Cha JM, Choi SI, Lee JI. Rectal syphilis mimicking rectal cancer. Yonsei Med J 2010; 51 (2) 276-278
  • 11 Cone LA, Woodard DR, Potts BE, Byrd RG, Alexander RM, Last MD. An update on the acquired immunodeficiency syndrome (AIDS). Associated disorders of the alimentary tract. Dis Colon Rectum 1986; 29 (1) 60-64
  • 12 Lavery EA, Coyle WJ. Herpes simplex virus and the alimentary tract. Curr Gastroenterol Rep 2008; 10 (4) 417-423
  • 13 Joseph D, Jin H, Ryan C, Chey WY. Resolution of anorectal incontinence in herpes proctitis confirmed by anorectal manometry. Gastrointest Endosc 1997; 45 (5) 429-432
  • 14 Rompalo AM. Diagnosis and treatment of sexually acquired proctitis and proctocolitis: an update. Clin Infect Dis 1999; 28 (Suppl. 01) S84-S90
  • 15 Voth ML, Akbari RP. Sexually transmitted proctitides. Clin Colon Rectal Surg 2007; 20 (1) 58-63
  • 16 Kaplowitz LG, Baker D, Gelb L , et al; The Acyclovir Study Group. Prolonged continuous acyclovir treatment of normal adults with frequently recurring genital herpes simplex virus infection. JAMA 1991; 265 (6) 747-751
  • 17 Smith PD, Quinn TC, Strober W, Janoff EN, Masur H. NIH conference. Gastrointestinal infections in AIDS. Ann Intern Med 1992; 116 (1) 63-77
  • 18 Keating J, Bjarnason I, Somasundaram S , et al. Intestinal absorptive capacity, intestinal permeability and jejunal histology in HIV and their relation to diarrhoea. Gut 1995; 37 (5) 623-629
  • 19 Veljkovic V, Metlas R, Raspopovic J, Pongor S. Spectral and sequence similarity between vasoactive intestinal peptide and the second conserved region of human immunodeficiency virus type 1 envelope glycoprotein (gp120): possible consequences on prevention and therapy of AIDS. Biochem Biophys Res Commun 1992; 15; 189 (2) 705-710
  • 20 U.S. Department of Health and Human Services Health Resources and Services Administration. Guide for HIV/AIDS Clinical Care. Rockville, MD: HIV/AIDS Bureau; January 2011. Available at: . Accessed on May 30, 2014.
  • 21 Sanchez TH, Brooks JT, Sullivan PS , et al; Adult/Adolescent Spectrum of HIV Disease Study Group. Bacterial diarrhea in persons with HIV infection, United States, 1992-2002. Clin Infect Dis 2005; 41 (11) 1621-1627
  • 22 Wilcox CM, Rabeneck L, Friedman S. AGA technical review: malnutrition and cachexia, chronic diarrhea, and hepatobiliary disease in patients with human immunodeficiency virus infection. Gastroenterology 1996; 111 (6) 1724-1752
  • 23 Kram HB, Shoemaker WC. Intestinal perforation due to cytomegalovirus infection in patients with AIDS. Dis Colon Rectum 1990; 33 (12) 1037-1040
  • 24 Rabinowitz M, Bassan I, Robinson MJ. Sexually transmitted cytomegalovirus proctitis in a woman. Am J Gastroenterol 1988; 83 (8) 885-887
  • 25 Studemeister A. Cytomegalovirus proctitis: a rare and disregarded sexually transmitted disease. Sex Transm Dis 2011; 38 (9) 876-878
  • 26 Bini EJ, Gorelick SM, Weinshel EH. Outcome of AIDS-associated cytomegalovirus colitis in the era of potent antiretroviral therapy. J Clin Gastroenterol 2000; 30 (4) 414-419
  • 27 Bizer LS, Pettorino R, Ashikari A. Emergency abdominal operations in the patient with acquired immunodeficiency syndrome. J Am Coll Surg 1995; 180 (2) 205-209