According to the Centers for Disease Control and Prevention, one in five American adults is infected with genital herpes. In some cases, genital herpes involves the anus and surround tissue. Anal herpes is most common among people who engage in anal-receptive intercourse; however it is also seen in people with no such history.
Anatomy
The anus is a 2 to 4 cm canal that is longer in men than women. It terminates inferiorly as a muscular loop known as the anal sphincter and superiorly as a part of the intestine called the rectum.
Blisters
Herpes causes two kinds of the lesions on the anus. The first kind is a 1 to 2mm fluid-filled blister that often develops in clusters on the lower part of the anus and the surrounding skin of the buttocks. Surgeons describe these lesions as "dewdrops on rose petals," according to a 2007 report in the journal "Clinics in Colon and Rectal Surgery."
Ulcers
The second kind of anal herpes lesion is a uniform shallow erosion of the surface layer of tissue commonly described as a "punch-out" lesion because of its well-defined borders. This lesion frequently affects the upper portion of the anus.
Discharge
In a 2009 study in the journal "Diseases of the Colon and Rectum," discharge was the most common complaint of people with anal herpes. The discharge is foul-smelling and may contain pus or blood.
Pain
Pain was the second most common complaint of patients with anal herpes in the "Diseases of the Colon and Rectum" study. Pain was described variously as generalized anorectal pain, painful bowel movements, tingling or burning over the anorectal area or buttocks, and shooting pain down the back of the thighs.
Change in Bowel Habits
People with anal herpes often report constipation, diarrhea or abnormal stool consistency. Tenesmus--feeling the urge to defecate when no stool is present--is another problem.
References
- Centers for Disease Control and Prevention: STD Facts -Genital Herpes
- "Clinics in Colon and Rectal Surgery"; Sexually Transmitted Proctides; M.L. Voth and R.P. Akbari; February 2007
- "Diseases of the Colon and Rectum"; Sexually Transmitted Infections as a Cause of Proctitis in Men Who Have Sex with Men; T.W. Davis and S.E. Goldstone; March 2009
