One in five American adults is infected with herpes, according to the Centers for Disease Control and Prevention (CDC). Proctitis, explain surgeons Matthew L. Voth and Robert P. Akbari of Temple University College of Medicine, is defined as inflammation located in, but not necessarily confined to, the rectum. Herpes proctitis is most common among people who engage in anal intercourse; however, some people with herpes proctitis report no such history. Herpes procititis symptoms can be divided into four categories.
Perianal Lesions
In many cases of herpes procititis the characteristic lesions of herpes can be seen on and around the anus. According to Voth and Akbari, perianal herpes lesions often have a "dewdrops on rose petals" appearance with tiny, fluid-filled blisters dotted over raised, red patches. The lesions are initially painful. After a few days they usually crust and become itchy.
Discharge
Herpes lesions typically rupture a few days after they appear, leaving behind superficial erosions. In herpes proctitis, these erosions are subject to mechanical trauma from bowel movements and secondary bacterial infections from bacteria in fecal matter. In a 2009 study in the medical journal "Diseases of the Colon and Rectum," blood in the stools, anal drainage of blood and pus and odor were the most common symptoms of herpes proctitis.
Pain
Lesions inside the rectum and intestine produce a different kind of pain and are more difficult to localize than skin lesions. In the same 2009 study, only 62 percent of men with confirmed herpes proctitis complained of pain. Specific kinds of pain reported included generalized anorectal pain, pain with bowel movements, tingling or burning over the anorectal area or buttocks and shooting pain down the back of the thighs. In some cases of herpes proctitis, the tender, pea-to-marble sized lumps in the groin may be found. These represent swollen inguinal lymph nodes.
Change in Bowel Habits
An often overlooked symptom of herpes proctitis may be change in bowel habits. According to the CDC, people with herpes proctitis may complain of constipation, diarrhea or abnormal stool consistency. If the disease is longstanding, there may be a history of weight loss.
References
- Centers for Disease Control and Prevention: Proctitis, Proctocolitis, and Enteritis
- 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
