What are the main causes of hemorrhoid STD. How can you recognize the symptoms of hemorrhoid STD. What are the most effective treatments for hemorrhoid STD. Are there any other conditions that can cause similar symptoms to hemorrhoid STD. How can you prevent hemorrhoid STD and related conditions.

Understanding Hemorrhoids and Their Relation to STDs

Hemorrhoids and sexually transmitted diseases (STDs) are often confused due to some overlapping symptoms. However, it’s crucial to understand that hemorrhoids themselves are not an STD. Hemorrhoids are swollen veins in the lower rectum and anus, while STDs are infections transmitted through sexual contact. Some STDs can cause symptoms similar to hemorrhoids, leading to confusion.

Common symptoms of hemorrhoids include:

• Itching around the anus
• Pain or discomfort during bowel movements
• Bleeding during bowel movements
• Swelling around the anus
• A lump near the anus that may be sensitive or painful

While these symptoms can be uncomfortable, they are generally not indicative of an STD. However, certain STDs can cause rectal symptoms that might be mistaken for hemorrhoids.

STDs That Can Cause Rectal Symptoms

Several sexually transmitted infections can lead to rectal symptoms that may be confused with hemorrhoids. Understanding these conditions is crucial for proper diagnosis and treatment.

Gonorrhea

Gonorrhea is a bacterial infection caused by Neisseria gonorrhoeae. When it affects the rectum, it can cause symptoms similar to hemorrhoids.

Rectal gonorrhea symptoms include:

• Anal discharge
• Anal itching
• Soreness and bleeding
• Painful bowel movements

Is gonorrhea always symptomatic? No, many people with rectal gonorrhea may not experience any symptoms, highlighting the importance of regular STI screenings.

Anal Herpes

Anal herpes is caused by the herpes simplex virus (HSV) types 1 or 2. It can cause symptoms that may be mistaken for hemorrhoids.

Symptoms of anal herpes include:

• Small blisters that burst, leaving inflamed and open sores
• Tingling, burning, or itching sensation
• Pain while urinating

Can anal herpes be asymptomatic? Yes, the Centers for Disease Control and Prevention (CDC) note that most people with herpes are asymptomatic or experience very mild symptoms.

Anal Warts

Anal warts are caused by the human papillomavirus (HPV). They can cause symptoms that may be confused with hemorrhoids.

Symptoms of anal warts include:

• Individual or large masses of warts around the anal area
• Warts that may bleed
• Itching or discomfort

Do all people with HPV develop anal warts? No, approximately 10% of people with HPV will develop genital warts, including anal warts.

Non-STD Conditions That Can Cause Rectal Itching

Rectal itching isn’t always a sign of an STD or hemorrhoids. Several other conditions can cause similar symptoms.

Yeast Infections

An anal yeast infection occurs when there’s an overgrowth of Candida bacteria. While not an STD, it can be transmitted through unprotected anal sex.

Symptoms of anal yeast infections include:

• Itching
• Burning
• Anal discharge
• Flushed or irritated skin
• Soreness

How common are anal yeast infections? Approximately 10% of people experiencing an itchy anus have a Candida infection.

Anal Fissures

Anal fissures are tears in the skin of the rectum and anus. They can cause symptoms similar to hemorrhoids and some STDs.

Symptoms of anal fissures include:

• Bleeding when passing a bowel movement
• Itching around the anus
• Intermittent pain while passing a bowel movement

What’s the most common cause of anal fissures? The majority of cases typically occur due to constipation or large stools that tear the lining of the anal canal.

Pinworms

Pinworms are small, thin white roundworms that can cause rectal itching. While not an STD, they can cause discomfort similar to other conditions.

How common are pinworm infections? According to the CDC, pinworm infection is the most common worm infection in the United States.

Diagnosis and Treatment of Rectal Conditions

Proper diagnosis is crucial for effective treatment of rectal conditions, whether they’re STDs, hemorrhoids, or other issues. A healthcare provider will typically perform a physical examination and may order tests to determine the cause of symptoms.

Diagnosing STDs

STDs are typically diagnosed through a combination of physical examination and laboratory tests. These may include:

• Swab tests of affected areas
• Blood tests
• Urine tests

How long does it take to get STD test results? The timeframe can vary depending on the type of test, but many results are available within a few days to a week.

Treating STDs

Treatment for STDs varies depending on the specific infection:

• Gonorrhea: Treated with a combination of antibiotics, typically ceftriaxone and azithromycin.
• Herpes: While there’s no cure, antiviral medications can help manage outbreaks and reduce transmission risk.
• Anal warts: Can be removed surgically or treated with topical medications, though 80% of cases clear spontaneously within 18-24 months.

Treating Non-STD Conditions

Treatment for other rectal conditions also varies:

• Hemorrhoids: Often treated with over-the-counter creams, lifestyle changes, or in severe cases, surgical procedures.
• Yeast infections: Typically treated with antifungal medications.
• Anal fissures: Often heal on their own with proper care, but may require medication or surgery in chronic cases.
• Pinworms: Treated with antiparasitic medications.

Prevention and Self-Care for Rectal Health

Maintaining good rectal health and preventing STDs and other conditions involves a combination of safe practices and self-care.

Preventing STDs

To reduce the risk of contracting or spreading STDs:

• Use condoms or dental dams during sexual activity
• Get regular STD screenings
• Limit sexual partners
• Communicate openly with sexual partners about STD status

How effective are condoms in preventing STDs? When used correctly and consistently, condoms are highly effective in preventing many STDs, though they don’t provide 100% protection.

Preventing Hemorrhoids and Other Rectal Conditions

To reduce the risk of developing hemorrhoids and other rectal issues:

• Maintain good hygiene
• Eat a high-fiber diet
• Stay hydrated
• Exercise regularly
• Avoid straining during bowel movements

Can dietary changes really help prevent hemorrhoids? Yes, a diet rich in fiber can help prevent constipation, which is a common cause of hemorrhoids.

When to Seek Medical Attention

While many rectal conditions can be managed at home, certain symptoms warrant immediate medical attention:

• Persistent or severe rectal pain
• Heavy rectal bleeding
• Fever accompanying rectal symptoms
• Persistent itching or discomfort that doesn’t respond to home treatments
• Any unusual lumps or growths around the anus

Should you wait for symptoms to worsen before seeing a doctor? No, it’s best to seek medical advice early if you’re experiencing persistent rectal symptoms. Early diagnosis and treatment can prevent complications and provide relief sooner.

Debunking Myths About Hemorrhoids and STDs

There are many misconceptions about hemorrhoids and STDs that can lead to unnecessary worry or delayed treatment. Let’s address some common myths:

Myth: All Rectal Itching is Caused by Hemorrhoids

While hemorrhoids are a common cause of rectal itching, they’re not the only cause. As we’ve discussed, various STDs and other conditions can cause similar symptoms. It’s important to get a proper diagnosis rather than assuming any rectal discomfort is due to hemorrhoids.

Myth: You Can’t Get an STD from Anal Sex

This is a dangerous misconception. Anal sex can indeed transmit STDs, sometimes even more easily than vaginal sex due to the delicate tissues involved. Always practice safe sex, regardless of the type of sexual activity.

Myth: Hemorrhoids are Contagious

Hemorrhoids are not contagious and cannot be spread from person to person. They’re simply swollen blood vessels, not an infectious condition.

Myth: Only Gay Men Get Anal STDs

Anyone who engages in anal sex, regardless of gender or sexual orientation, can contract an anal STD. It’s important to practice safe sex and get regular screenings regardless of your sexual preferences.

Do these myths contribute to the spread of STDs? Yes, misconceptions about STDs and safe sex practices can lead to risky behavior and increased transmission rates. Education is key in preventing the spread of STDs.

Living with Chronic Rectal Conditions

For some individuals, rectal conditions like chronic hemorrhoids or recurring STDs can be an ongoing challenge. Learning to manage these conditions effectively is crucial for maintaining quality of life.

Managing Chronic Hemorrhoids

If you’re prone to hemorrhoids, consider these long-term management strategies:

• Maintain a high-fiber diet to prevent constipation
• Use a sitz bath for relief during flare-ups
• Consider over-the-counter creams or suppositories for symptom relief
• Discuss surgical options with your doctor for severe, recurring cases

Can lifestyle changes really make a difference in managing chronic hemorrhoids? Yes, many people find significant relief from hemorrhoid symptoms through dietary and lifestyle modifications.

Living with Recurring STDs

For individuals with chronic STDs like herpes, management strategies include:

• Taking suppressive antiviral therapy to reduce outbreaks
• Learning to recognize and manage triggers for outbreaks
• Practicing safe sex to prevent transmission to partners
• Joining support groups to connect with others facing similar challenges

How can people with chronic STDs maintain healthy relationships? Open communication, practicing safe sex, and proper disease management are key to maintaining healthy relationships while living with a chronic STD.

The Importance of Sexual Health Education

Comprehensive sexual health education plays a crucial role in preventing STDs and promoting overall sexual wellness. Understanding your body, recognizing potential symptoms, and knowing when to seek medical attention are all vital aspects of maintaining good sexual health.

Promoting Safe Sex Practices

Education about safe sex practices is essential for preventing the spread of STDs. This includes:

• Proper condom use
• Understanding the risks associated with different sexual activities
• Recognizing the importance of regular STD screenings
• Learning about available preventive measures like PrEP for HIV

Does comprehensive sex education reduce STD rates? Studies have shown that comprehensive sex education can indeed lead to lower rates of STDs and unintended pregnancies.

Reducing Stigma

Education also plays a crucial role in reducing the stigma associated with STDs and other sexual health issues. By promoting open, honest discussions about sexual health, we can create an environment where people feel comfortable seeking information and medical care when needed.

How does stigma impact STD rates? Stigma can prevent people from getting tested or seeking treatment, which can lead to increased transmission rates. Reducing stigma through education is an important part of STD prevention efforts.

In conclusion, while hemorrhoids and STDs can cause similar symptoms, they are distinct conditions requiring different approaches to treatment and prevention. By understanding the causes, symptoms, and treatments for these conditions, as well as practicing safe sex and maintaining good overall health, individuals can better manage their rectal and sexual health. Remember, when in doubt, it’s always best to consult with a healthcare professional for proper diagnosis and treatment.

Causes, other symptoms, and treatment

Some sexually transmitted infections (STIs), such as anal herpes or gonorrhea, can cause rectal itching. However, it is also possible that the itching results from other conditions, such as anal fissures or hemorrhoids.

In this article, we will discuss which STIs can cause rectal itching, and how to treat them. We also look at other conditions that can cause rectal itching.

Gonorrhea is the result of the Neisseria gonorrhoeae bacteria.

According to the Centers for Disease Control and Prevention (CDC), gonorrhea is a very common STI, affecting around 1.14 million people in the United States every year.

People can contract it via sexual contact with the genitals, mouth, or anus of a person who has gonorrhea.

Symptoms of rectal gonorrhea include:

• anal discharge
• anal itching
• soreness and bleeding
• painful bowel movements

However, not everyone with rectal gonorrhea will have symptoms. That is why it is important to have regular STI screenings.

Learn more about gonorrhea here.

Treatment

Treatment for gonorrhea involves a combination of ceftriaxone and azithromycin, which are antibiotics.

It is important that a person abstains from sexual activity for 1 week after treatment. This helps prevent passing the infection on to others.

Anal herpes is the result of herpes simplex virus type 1 or herpes simplex virus type 2.

People can contract herpes if they come into contact with:

• herpes lesions
• mucosal surfaces, such as the vagina or rectum
• genital and oral secretions

Symptoms of anal herpes include:

• small blisters that burst, leaving inflamed and open sores
• tingling, burning, or itching sensation
• pain while urinating

The CDC note that most people who have herpes are asymptomatic, meaning that they do not have any symptoms. Others may only experience very mild symptoms.

If symptoms do appear, the first outbreak of herpes lasts for approximately 2–4 weeks, and a person may also experience flu-like symptoms.

Learn more about anal herpes here.

Treatment

To diagnose herpes, doctors will take a culture of a sore or perform a blood test.

There is currently no cure for herpes. However, doctors can prescribe antiviral medications.

These can shorten the amount of time an outbreak lasts and reduce the chance of passing this infection on to others.

Anal warts are the result of the human papillomavirus (HPV). One 2020 article notes that approximately 10% of people who have HPV will develop genital warts.

Symptoms of anal warts include:

• individual or large masses of warts around the anal area
• warts that may bleed
• itching or discomfort

Learn more about anal warts here.

Treatment

There is no cure for anal warts. However, the article states that 80% of people will spontaneously clear the infection within 18–24 months.

A doctor can surgically remove the warts or prescribe topical agents.

Rectal itching may not be the result of an STI.

The following can also cause a person to experience an itchy anus. However, the list is not exhaustive, and therefore a person should contact a doctor if they are experiencing rectal itching.

Yeast infection

An anal yeast infection occurs when there is an overgrowth of the Candida bacteria.

One 2016 article notes that Candida infections are present in approximately 10% of those experiencing an itchy anus.

Although an anal yeast infection is not an STI, a person can transmit or develop it via anal sex without the use of a condom or other barrier method.

Alongside itching, a person may experience:

• burning
• anal discharge
• flushed or irritated skin
• soreness

Learn more about anal yeast infections here.

Hemorrhoids

Hemorrhoids, or piles, are swollen veins that appear inside and around the anus.

Symptoms of internal hemorrhoids include:

• itching, bleeding, pain, or burning in the anus
• mucous discharge from the anus
• swelling

Learn more about hemorrhoids here.

Anal fissure

Anal fissures are tears in the skin in the rectum and anus. The United Kingdom’s National Health Service (NHS) note that the majority of cases typically occur due to constipation or large stools that tear the lining of the anal canal.

However, anal fissures may occasionally occur due to STIs, such as syphilis or herpes. This is because they can infect and damage the anal canal.

Some anal fissures can last for more than 6 weeks.

Symptoms of anal fissures include:

• bleeding when passing a bowel movement
• itching around the anus
• intermittent pain while passing a bowel movement

Learn more about anal fissures here.

Pinworms

Pinworms are small thin white roundworms called Enterobius vermicularis. The CDC state that pinworm infection is the most common worm infection in the U.S.

People can contract pinworms after ingesting pinworm eggs. This can happen after swallowing the eggs that may be present on fingers, clothing, food, and other contaminated objects.

While a person sleeps, the female pinworm travels to the anal area and lays its eggs around the anus.

Symptoms can be mild, and some people do not experience any. However, the most common symptom is rectal itching. Other symptoms may include:

• redness and swelling
• watery diarrhea
• abdominal pain

A person may also be able to see the worms and their eggs on the skin near the anus approximately 2–3 hours after a person falls asleep.

Learn more about pinworms here.

Irritants

Certain irritants can lead to skin conditions, such as eczema or psoriasis. This can lead to anal itching, inflammation, swelling, and pain.

The most common irritants that may cause anal itching include:

• soaps
• shampoos
• recycled toilet paper
• intimate hygiene wipes
• certain foods, especially those that contain nickel

A person should always contact a doctor if they are concerned that they have contracted an STI.

However, according to the NHS, a person can try the following to provide relief from the itching:

• gently washing and drying the anus after having a bowel movement, and before bed
• wearing loose-fitting cotton underwear
• bathing or showering in lukewarm water
• eating plenty of fiber, such as fruit and vegetables and pasta
• avoiding wiping after having a bowel movement, and instead washing with water or using moist toilet paper and patting dry
• avoiding scratching on and around the anus
• avoiding fragranced products, such as soaps
• avoiding eating spicy food and drinking alcohol and caffeine

It is important to contact a doctor if a person is concerned that they have contracted an STI or if a sexual partner informs them that they have an STI.

People should also consult a doctor if any rectal itching does not resolve.

Several STIs can cause anal itching, such as herpes, anal warts, and gonorrhea. However, with medical treatment, people can manage the symptoms or cure the infection.

Rectal itching can also occur due to other conditions, such as anal fissures, irritants, or hemorrhoids.

Although a person may be able to manage the itching at home, it is important to contact a doctor if they are concerned or if the itching does not resolve.

Sexually transmitted infections of the anus and rectum

1. Sultan S. Sexually transmissible infections of the anus and the rectum. Rev Prat. 2008;58:1793–1801. [PubMed] [Google Scholar]

2. Cates W. Estimates of the incidence and prevalence of sexually transmitted diseases in the United States. American Social Health Association Panel. Sex Transm Dis. 1999;26:S2–S7. [PubMed] [Google Scholar]

3. Wexner SD. Sexually transmitted diseases of the colon, rectum, and anus. The challenge of the nineties. Dis Colon Rectum. 1990;33:1048–1062. [PubMed] [Google Scholar]

4. Halperin DT. Heterosexual anal intercourse: prevalence, cultural factors, and HIV infection and other health risks, Part I. AIDS Patient Care STDS. 1999;13:717–730. [PubMed] [Google Scholar]

5. Kent CK, Chaw JK, Wong W, Liska S, Gibson S, Hubbard G, Klausner JD. Prevalence of rectal, urethral, and pharyngeal chlamydia and gonorrhea detected in 2 clinical settings among men who have sex with men: San Francisco, California, 2003. Clin Infect Dis. 2005;41:67–74. [PubMed] [Google Scholar]

6. Gambotti L, Batisse D, Colin-de-Verdiere N, Delaroque-Astagneau E, Desenclos JC, Dominguez S, Dupont C, Duval X, Gervais A, Ghosn J, et al. Acute hepatitis C infection in HIV positive men who have sex with men in Paris, France, 2001-2004. Euro Surveill. 2005;10:115–117. [PubMed] [Google Scholar]

7. Craib KJ, Meddings DR, Strathdee SA, Hogg RS, Montaner JS, O’Shaughnessy MV, Schechter MT. Rectal gonorrhoea as an independent risk factor for HIV infection in a cohort of homosexual men. Genitourin Med. 1995;71:150–154. [PMC free article] [PubMed] [Google Scholar]

8. Fleming DT, Wasserheit JN. From epidemiological synergy to public health policy and practice: the contribution of other sexually transmitted diseases to sexual transmission of HIV infection. Sex Transm Infect. 1999;75:3–17. [PMC free article] [PubMed] [Google Scholar]

9. Perez G, Skurnick JH, Denny TN, Stephens R, Kennedy CA, Regivick N, Nahmias A, Lee FK, Lo SC, Wang RY, et al. Herpes simplex type II and Mycoplasma genitalium as risk factors for heterosexual HIV transmission: report from the heterosexual HIV transmission study. Int J Infect Dis. 1998;3:5–11. [PubMed] [Google Scholar]

10. Schwarcz SK, Kellogg TA, McFarland W, Louie B, Klausner J, Withum DG, Katz MH. Characterization of sexually transmitted disease clinic patients with recent human immunodeficiency virus infection. J Infect Dis. 2002;186:1019–1022. [PubMed] [Google Scholar]

11. Dougan S, Evans BG, Elford J. Sexually transmitted infections in Western Europe among HIV-positive men who have sex with men. Sex Transm Dis. 2007;34:783–790. [PubMed] [Google Scholar]

12. Cohen MS, Hoffman IF, Royce RA, Kazembe P, Dyer JR, Daly CC, Zimba D, Vernazza PL, Maida M, Fiscus SA, et al. Reduction of concentration of HIV-1 in semen after treatment of urethritis: implications for prevention of sexual transmission of HIV-1. AIDSCAP Malawi Research Group. Lancet. 1997;349:1868–1873. [PubMed] [Google Scholar]

13. Kofoed K, Gerstoft J, Mathiesen LR, Benfield T. Syphilis and human immunodeficiency virus (HIV)-1 coinfection: influence on CD4 T-cell count, HIV-1 viral load, and treatment response. Sex Transm Dis. 2006;33:143–148. [PubMed] [Google Scholar]

14. Felt-Bersma RJ, Bartelsman JF. Haemorrhoids, rectal prolapse, anal fissure, peri-anal fistulae and sexually transmitted diseases. Best Pract Res Clin Gastroenterol. 2009;23:575–592. [PubMed] [Google Scholar]

15. Roberts CM, Pfister JR, Spear SJ. Increasing proportion of herpes simplex virus type 1 as a cause of genital herpes infection in college students. Sex Transm Dis. 2003;30:797–800. [PubMed] [Google Scholar]

16. Engelberg R, Carrell D, Krantz E, Corey L, Wald A. Natural history of genital herpes simplex virus type 1 infection. Sex Transm Dis. 2003;30:174–177. [PubMed] [Google Scholar]

17. Goodell SE, Quinn TC, Mkrtichian E, Schuffler MD, Holmes KK, Corey L. Herpes simplex virus proctitis in homosexual men. Clinical, sigmoidoscopic, and histopathological features. N Engl J Med. 1983;308:868–871. [PubMed] [Google Scholar]

18. Hamlyn E, Taylor C. Sexually transmitted proctitis. Postgrad Med J. 2006;82:733–736. [PMC free article] [PubMed] [Google Scholar]

19. Workowski KA, Berman S; Centers for Disease Control and Prevention (CDC) Sexually transmitted diseases treatment guidelines, 2010. MMWR Recomm Rep. 2010;59:1–110. [PubMed] [Google Scholar]

20. Townsend Jr. CM. Anus: Neoplastic Disorders. Sabiston textbook of Surgery: The Biological Basis of Modern Surgical Practice. 19th ed. Philadelphia: Elsevier Saunders; 2012. [Google Scholar]

21. Gunter J. Genital and perianal warts: new treatment opportunities for human papillomavirus infection. Am J Obstet Gynecol. 2003;189:S3–11. [PubMed] [Google Scholar]

22. Lorincz AT, Temple GF, Kurman RJ, Jenson AB, Lancaster WD. Oncogenic association of specific human papillomavirus types with cervical neoplasia. J Natl Cancer Inst. 1987;79:671–677. [PubMed] [Google Scholar]

23. El-Attar SM, Evans DV. Anal warts, sexually transmitted diseases, and anorectal conditions associated with human immunodeficiency virus. Prim Care. 1999;26:81–100. [PubMed] [Google Scholar]

24. Baldwin SB, Wallace DR, Papenfuss MR, Abrahamsen M, Vaught LC, Giuliano AR. Condom use and other factors affecting penile human papillomavirus detection in men attending a sexually transmitted disease clinic. Sex Transm Dis. 2004;31:601–607. [PubMed] [Google Scholar]

25. Beck D. Sexually transmitted diseases. The ASCRS Textbook of Colon and Rectal Surgery. 2nd ed. New York: Springer; 2011. pp. 295–307. [Google Scholar]

26. Buschke A, Lowenstein L. Uber carcinomahnliche condylomata acuminata des penis. Klin Wochenschr. 1925;4:1726–1728. [Google Scholar]

27. Barillo DJ, Coffey EC, Shirani KZ, Goodwin CW. Burns caused by medical therapy. J Burn Care Rehabil. 2000;21:269–273; discussion 268. [PubMed] [Google Scholar]

28. Cosentino LA, Campbell T, Jett A, Macio I, Zamborsky T, Cranston RD, Hillier SL. Use of nucleic acid amplification testing for diagnosis of anorectal sexually transmitted infections. J Clin Microbiol. 2012;50:2005–2008. [PMC free article] [PubMed] [Google Scholar]

29. Litt EJ, Ziesche R, Happak W, Lumenta DB. Burning HOT: revisiting guidelines associated with home oxygen therapy. Int J Burns Trauma. 2012;2:167–170. [PMC free article] [PubMed] [Google Scholar]

30. Greaves AB. The frequency of lymphogranuloma venereum in persons with perirectal abscesses, fistulae in ano, or both. with particular reference to the relationship between perirectal abscesses of lymphogranuloma origin in the male and inversion. Bull World Health Organ. 1963;29:797–801. [PMC free article] [PubMed] [Google Scholar]

31. Ina K, Kusugami K, Ohta M. Bacterial hemorrhagic enterocolitis. J Gastroenterol. 2003;38:111–120. [PubMed] [Google Scholar]

32. Quinn TC, Goodell SE, Mkrtichian E, Schuffler MD, Wang SP, Stamm WE, Holmes KK. Chlamydia trachomatis proctitis. N Engl J Med. 1981;305:195–200. [PubMed] [Google Scholar]

33. Tinmouth J, Gilmour MW, Kovacs C, Kropp R, Mitterni L, Rachlis A, Richards S, Salit I, Sikri R, Valencia GR, et al. Is there a reservoir of sub-clinical lymphogranuloma venereum and non-LGV Chlamydia trachomatis infection in men who have sex with men? Int J STD AIDS. 2008;19:805–809. [PubMed] [Google Scholar]

34. Centers for Disease Control and Prevention. Trends in reportable sexually transmitted diseases in the United States, 2007: National surveillance data for chlamydia, gonorrhea, and syphilis. Available from: http://www.cdc.gov/std/stats07/trends.pdf. Accessed May 21, 2014.

35. Centers for Disease Control and Prevention. STD trends in the United States: 2010 national data for gonorrhea, chlamydia, and syphilis. Available from: http://www.cdc.gov/std/stats10/trends2010.pdf. Accessed May 21, 2014.

36. Miles AJ, Mellor CH, Gazzard B, Allen-Mersh TG, Wastell C. Surgical management of anorectal disease in HIV-positive homosexuals. Br J Surg. 1990;77:869–871. [PubMed] [Google Scholar]

37. Wexner SD, Smithy WB, Milsom JW, Dailey TH. The surgical management of anorectal diseases in AIDS and pre-AIDS patients. Dis Colon Rectum. 1986;29:719–723. [PubMed] [Google Scholar]

38. Barrett WL, Callahan TD, Orkin BA. Perianal manifestations of human immunodeficiency virus infection: experience with 260 patients. Dis Colon Rectum. 1998;41:606–611; discussion 611-612. [PubMed] [Google Scholar]

39. Nadal SR, Manzione CR, Galvão VM, Salim VR, Speranzini MB. Perianal diseases in HIV-positive patients compared with a seronegative population. Dis Colon Rectum. 1999;42:649–654. [PubMed] [Google Scholar]

40. Morandi E, Merlini D, Salvaggio A, Foschi D, Trabucchi E. Prospective study of healing time after hemorrhoidectomy: influence of HIV infection, acquired immunodeficiency syndrome, and anal wound infection. Dis Colon Rectum. 1999;42:1140–1144. [PubMed] [Google Scholar]

41. Modesto VL, Gottesman L. Surgical debridement and intralesional steroid injection in the treatment of idiopathic AIDS-related anal ulcerations. Am J Surg. 1997;174:439–441. [PubMed] [Google Scholar]

42. Schmitt SL, Wexner SD, Nogueras JJ, Jagelman DG. Is aggressive management of perianal ulcers in homosexual HIV-seropositive men justified? Dis Colon Rectum. 1993;36:240–246. [PubMed] [Google Scholar]

43. Kaplan JE, Benson C, Holmes KK, Brooks JT, Pau A, Masur H. Guidelines for prevention and treatment of opportunistic infections in HIV-infected adults and adolescents: recommendations from CDC, the National Institutes of Health, and the HIV Medicine Association of the Infectious Diseases Society of America. MMWR Recomm Rep. 2009;58:1–207; quiz CE1-4. [PubMed] [Google Scholar]

44. Piketty C, Darragh TM, Da Costa M, Bruneval P, Heard I, Kazatchkine MD, Palefsky JM. High prevalence of anal human papillomavirus infection and anal cancer precursors among HIV-infected persons in the absence of anal intercourse. Ann Intern Med. 2003;138:453–459. [PubMed] [Google Scholar]

45. Piketty C, Darragh TM, Heard I, Da Costa M, Bruneval P, Kazatchkine MD, Palefsky JM. High prevalence of anal squamous intraepithelial lesions in HIV-positive men despite the use of highly active antiretroviral therapy. Sex Transm Dis. 2004;31:96–99. [PubMed] [Google Scholar]

46. Goldie SJ, Kuntz KM, Weinstein MC, Freedberg KA, Palefsky JM. Cost-effectiveness of screening for anal squamous intraepithelial lesions and anal cancer in human immunodeficiency virus-negative homosexual and bisexual men. Am J Med. 2000;108:634–641. [PubMed] [Google Scholar]

47. Goldie SJ, Kuntz KM, Weinstein MC, Freedberg KA, Welton ML, Palefsky JM. The clinical effectiveness and cost-effectiveness of screening for anal squamous intraepithelial lesions in homosexual and bisexual HIV-positive men. JAMA. 1999;281:1822–1829. [PubMed] [Google Scholar]

48. Giuliano AR, Palefsky JM, Goldstone S, Moreira ED, Penny ME, Aranda C, Vardas E, Moi H, Jessen H, Hillman R, et al. Efficacy of quadrivalent HPV vaccine against HPV Infection and disease in males. N Engl J Med. 2011;364:401–411. [PMC free article] [PubMed] [Google Scholar]

49. Palefsky JM, Giuliano AR, Goldstone S, Moreira ED, Aranda C, Jessen H, Hillman R, Ferris D, Coutlee F, Stoler MH, et al. HPV vaccine against anal HPV infection and anal intraepithelial neoplasia. N Engl J Med. 2011;365:1576–1585. [PubMed] [Google Scholar]

50. 1993 revised classification system for HIV infection and expanded surveillance case definition for AIDS among adolescents and adults. MMWR Recomm Rep. 1992;41:1–19. [PubMed] [Google Scholar]

51. Beral V, Peterman TA, Berkelman RL, Jaffe HW. Kaposi‘s sarcoma among persons with AIDS: a sexually transmitted infection? Lancet. 1990;335:123–128. [PubMed] [Google Scholar]

52. Engels EA, Pfeiffer RM, Goedert JJ, Virgo P, McNeel TS, Scoppa SM, Biggar RJ. Trends in cancer risk among people with AIDS in the United States 1980-2002. AIDS. 2006;20:1645–1654. [PubMed] [Google Scholar]

53. International Collaboration on HIV and Cancer. Highly active antiretroviral therapy and incidence of cancer in human immunodeficiency virus-infected adults. J Natl Cancer Inst. 2000;92:1823–1830. [PubMed] [Google Scholar]

54. Yuhan R, Orsay C, DelPino A, Pearl R, Pulvirenti J, Kay S, Abcarian H. Anorectal disease in HIV-infected patients. Dis Colon Rectum. 1998;41:1367–1370. [PubMed] [Google Scholar]

55. Donato V, Guarnaccia R, Dognini J, de Pascalis G, Caruso C, Bellagamba R, Morrone A. Radiation therapy in the treatment of HIV-related Kaposi’s sarcoma. Anticancer Res. 2013;33:2153–2157. [PubMed] [Google Scholar]

56. Epstein JB. Treatment of oral Kaposi sarcoma with intralesional vinblastine. Cancer. 1993;71:1722–1725. [PubMed] [Google Scholar]

57. McCormick SU. Intralesional vinblastine injections for the treatment of oral Kaposi’s sarcoma: report of 10 patients with 2-year follow-up. J Oral Maxillofac Surg. 1996;54:583–587; discussion 588- 589. [PubMed] [Google Scholar]

58. Bower M, Collins S, Cottrill C, Cwynarski K, Montoto S, Nelson M, Nwokolo N, Powles T, Stebbing J, Wales N, et al. British HIV Association guidelines for HIV-associated malignancies 2008. HIV Med. 2008;9:336–388. [PubMed] [Google Scholar]

Hemorrhoids and its treatment

back to the outpatient surgery department

HEMORRHOIDS TREATMENT

Hemorrhoids and varicose veins.
Some people are surprised to learn that hemorrhoids are actually varicose veins located around the anus. This disease is very common in Russia. By the age of fifty, about half of the adult population is faced with itching, pain, blood in the stool, which usually indicates hemorrhoids.

Fig. Internal and external hemorrhoids

What are hemorrhoids?
In fact, hemorrhoids are nothing more than varicose veins of the anal canal and rectum, which form cavernous formations – the so-called hemorrhoids. Experts distinguish two types of hemorrhoids – external and internal – depending on the location in the anal canal. External hemorrhoids form in the immediate vicinity of the anus. Internal hemorrhoids form at the point where the anal canal passes into the rectum.

What are the symptoms of hemorrhoids?
The most characteristic symptoms of the disease are the prolapse of hemorrhoids during defecation (emptying the intestines), bleeding, the admixture of red blood in the stool, itching, foreign body (“painful bumps”), pain in the anal canal and rectum. Like any varicose vein, hemorrhoids can thrombose, causing severe pain. In the early stages of the disease, hemorrhoids can fall out during bowel movements, but then they can easily be set back on their own. In later stages, they require manual reduction. In the future, hemorrhoids may begin to fall out with any load, sometimes even with a cough. Over time, the fallen out hemorrhoids cease to be reduced and remain outside constantly. At this stage, the disease goes extremely far, which requires immediate treatment to a specialist. A complication of this disease is necrosis of the hemorrhoidal node, the appearance of severe bleeding or acute purulent paraproctitis

Fig. Stages of hemorrhoids

Who usually suffers from hemorrhoids?
Anyone can be affected by this disease. Predisposed to this disease are people who lead a sedentary lifestyle – drivers and office workers; people who do not follow a diet – abusing alcohol, spicy foods, and also regularly engaged in hard physical labor, including some athletes – weightlifters, shot putters.
Predisposing factors also include prolonged constipation. Hereditary predisposition also plays an important role in the development of the disease. Often, hemorrhoids develop during pregnancy, which is associated with increased pressure in the abdominal cavity.

How to treat hemorrhoids?
Various treatments for hemorrhoids are available today, depending on the stage of the disease and the severity of the symptoms.
Conservative treatment is carried out in the early stages of the development of the disease and consists in adjusting the diet, lifestyle and taking specific medications.

Traditional dietary recommendations for hemorrhoids include the following:

• Eat 0.5-1.0 kg of vegetables or fruits daily, add bran to the diet.
• Drink at least 1.5-2 liters of fluid per day.
• Prefer wholemeal bread.
• Eliminate spicy, fried, smoked foods, and alcohol from your diet.
• And finally stop smoking!!!
• Do not suppress the urge to defecate.

Surgical treatment of hemorrhoids.
Relatively few patients require surgery. The choice of a specific method depends on the severity of the symptoms and the stage of the disease. Persistent positive results in most patients can be achieved by following a diet regime and correcting lifestyle.
Surgical treatment of hemorrhoids today – outpatient operations hemorrhoidectomy or ligation of hemorrhoids .

Hemorrhoidectomy.
Hemorrhoidectomy, a traditional operation to remove hemorrhoids, is the “gold standard” surgical treatment of stage IV hemorrhoids, as well as thrombosis of prolapsed hemorrhoids. The intervention is usually performed under spinal or epidural anesthesia. The essence of the intervention is to excise a section of the skin or mucous membrane located above the hemorrhoid, which is stitched and intersected. If necessary, the operation can be supplemented by the use of electrocoagulation or a laser.
After surgery, be sure to observe a period of restriction of activity and strictly follow dietary recommendations.
The likelihood of recurrence after hemorrhoidectomy is rather small, but it should be remembered that the pathogenesis of hemorrhoids is varicose veins, and, therefore, new varicose nodes can form in the absence of recurrence of old ones. The possibility of recurrence and progression of the disease increases significantly if dietary and lifestyle recommendations are not followed.

Ligation of hemorrhoids with latex rings.
At present, a simple and effective outpatient method of treating internal hemorrhoids is widely used – ligation of hemorrhoids with latex rings.
This method of treatment is used in patients with II-III stages of hemorrhoids.
The essence of the method is to apply a small latex ring to the base of the hemorrhoid, which compresses it and thus stops the blood flow. Within a few days, the node dies and falls off along with the ring. A small wound forms at the site of the node, which heals on its own within 1-2 weeks.
As mentioned above, this manipulation is performed on an outpatient basis, takes about 10 minutes and does not cause disability. During the first two days after the manipulation, most patients note the feeling of a foreign body in the anal canal and minor pain, which is relieved by taking conventional analgesics.
According to modern research, ligation of hemorrhoids with latex rings avoids hemorrhoidectomy in approximately 80% of patients with hemorrhoids. Thus, to date, ligation with latex rings is the most promising, effective and radical method of treating hemorrhoids.

Laser hemorrhoid removal: the essence of the method

Laser hemorrhoid removal surgery or laser coagulation is a high-tech procedure that can be applied at stages 1-3 of the disease. Using this method allows you to get rid of internal and external hemorrhoids in the most gentle way.

Fig. Laser hemorrhoid removal scheme

The efficiency of the laser is that it is able to simultaneously cut and cauterize tissue. The thermal effect of the laser beam cauterizes tissues and blood vessels. Therefore, laser therapy is completely bloodless, the risk of infection is minimal, and patients tolerate such an intervention much more easily than with traditional methods.
The essence of the procedure is the layer-by-layer burning of hemorrhoids. In their place, small wounds remain, which soon crust over and heal. In the presence of external hemorrhoids, everything is even simpler – the laser simply cuts off the node at its leg and coagulates the wound with blood vessels, which ensures that there is no bleeding.

Indications for laser hemorrhoidectomy:

1. Chronic internal hemorrhoids of 1-3 degrees.
2. External varices.
3. Thrombosis of external nodes.

Contraindications to laser hemorrhoidectomy:

1. Advanced stage of hemorrhoids (4th).
2. Acute infectious processes in the anal area. In the presence of acute infectious processes, it is necessary to carry out preliminary conservative treatment until the inflammation subsides.
3. Chronic diseases in the stage of decompensation.

acute and chronic. Symptoms of hemorrhoids. Treatment of hemorrhoids in St. Petersburg

Hemorrhoids is considered to be one of the most common human diseases. Although estimates vary, it is safe to say that in Europe, hemorrhoids occur in 30-40% of people over 50 years of age.

Until recently, hemorrhoids were considered varicose veins of the rectum. But the fact that in patients with hemorrhoids there are not only venous, but also arterial bleeding, contradicts this theory.

Histological examination of hemorrhoids showed that they consist of a special cavernous (cavernous) tissue formed by numerous arteriovenous anastomoses (fusions of arteries and veins). In the process of human embryonic development, three cavernous (cavernous) bodies are laid in the anal canal – on the right anterior-lateral, left lateral and right posterior-lateral walls. It is in these places that the three main internal hemorrhoids are formed.

These hemorrhoids are formed as a result of impaired microcirculation in the cavernous tissue of the rectum. At the same time, the lumen of the anastomoses expands, the inflow of arterial blood increases, and the diameter of the efferent veins decreases. Microcirculation is negatively affected by both unfavorable environmental conditions and the state of the human body itself (frequent constipation, sedentary work or physical inactivity, pregnancy and attempts during childbirth).

Hemorrhoids may be asymptomatic. Approximately 10-12% of people with hemorrhoids do not feel any discomfort from their disease. However, with rectoscopic and Colonoscopy shows purple vascular growths at the locations of three cavernous bodies. Although asymptomatic hemorrhoids do not need to be treated, they should be detected early. In this case, preventive measures give a good result – a change in the mode of work and life, the correct and even distribution of physical activity, the selection of the right diet and the prevention of constipation.

Modern proctology distinguishes two forms of the course of the disease – chronic and acute hemorrhoids.

With both forms of hemorrhoids, a person can experience complications such as thrombosis, bleeding, inflammation, and prolapse of hemorrhoids. Drug treatment helps to stop the exacerbation, but gives only temporary relief.

Symptoms of chronic hemorrhoids:

• Itching and burning in the anal area.
• Pain in the anus during stool or as a result of long forced sitting in one place.
• Defecation is accompanied by slight bleeding.
• If the patient strains, sneezes, coughs, or walks a lot, hemorrhoids may prolapse from the anal canal.

Surgical treatment of hemorrhoids

Nowadays, proctology has a whole arsenal of methods for the surgical treatment of hemorrhoids.

• Hemorrhoidectomy in its various modifications (surgical removal of hemorrhoids).
• Sclerotherapy.
• Ligation (ligation) of hemorrhoids with latex rings.
• Infrared photocoagulation.
• Ligation of hemorrhoidal arteries under the control of ultrasound Doppler.
• Laser submucosal destruction of hemorrhoids.

Doctor-proctologist examines the stage of the patient’s disease and the complications that have arisen, and only then decides on one or another surgical method for treating hemorrhoids. For example, sclerotherapy and infrared photocoagulation are performed only in the early stages of the disease and most often on an outpatient basis. The same applies to the ligation of hemorrhoids with latex rings.

Submucous laser destruction (LHP)

Submucosal laser destruction is usually prescribed to patients both at the earliest stages of the disease and at later stages. A huge advantage of this surgical intervention is the possibility of its outpatient application.

With the help of a laser, hemorrhoids in the cavernous tissue are evaporated from the inside, without causing any harm to the rectal mucosa. Subsequently, the node collapses and scars.

The whole operation takes 15-20 minutes. The patient can go home within a few hours. The recovery postoperative period is not associated with severe pain. This type of operation can be performed even if there are other pathologies of the rectum – anal polyps, fistulas and fissures.

Surgical treatment of hemorrhoids in a hospital

If the patient suffers from stage 3-4 hemorrhoids or complications of hemorrhoids, then the patient is shown treatment in a hospital. The doctor recommends either dearterialization (HAL-RAR), or complete removal of hemorrhoids (hemorrhoidectomy), or a combined intervention is chosen. It is produced in a hospital due to the long rehabilitation of the patient after it.

A person remains under the supervision of specialists for a month due to possible severe pain during the recovery period. Most often, it is the fear of postoperative pain that causes patients to refuse hemorrhoidectomy, then the doctor selects a different method of treating hemorrhoids (if possible).

Hemorrhoidectomy with LigaSure

The proctologists of our clinic in St. Petersburg sometimes use a more gentle method of hemorrhoidectomy and perform it using the LigaSure device. This device allows you to remove hemorrhoids through rapid bipolar electrocoagulation, which eliminates the need for suturing. The duration of the operation is only 10-20 minutes, and the patient after it must be in the hospital for 1-2 days, instead of 4-7. This method allows you to reduce the level of discomfort during the postoperative period, and achieve a full recovery in 3-4 weeks.

HAL-RAR dezarterization

In 1996, the Japanese doctor Morinaga proposed to ligate the hemorrhoidal vessels under Doppler control. Currently, this high-tech operation is recommended for patients with stage 3 hemorrhoids or patients suffering from hemorrhoidal bleeding.

During the operation, the terminal branches of the superior rectal artery are ligated. It is through it that blood enters the hemorrhoids. After that, the nodes falling out of the rectum are pulled up and they are also ligated.

This procedure is called HAL-RAR or desarterization or Doppler-guided hemorrhoidal artery ligation.

Even compared to the previous one, this method of surgical intervention has a number of advantages:

• The operation eliminates the very cause of the disease – excessive arterial blood flow to the hemorrhoids.
• The operation allows you to restore the natural position of the nodes and fix them in it, which protects them from falling out.
• After surgery, there are no wounds in the anal canal.
• Hospitalization takes only 1-2 days.
• The patient’s ability to work is restored in 5-7 days after the operation.