Proctitis means inflammation of the rectum. It is caused by germs like chlamydia, gonorrhoea and herpes. Recently a new more aggressive type of chlamydia called LGV has spread amongst gay men in Europe. LGV causes much more severe symptoms. Some chemicals can be irritating to the anal lining so interesting lubes can cause problems sometimes. Some people get proctitis without any infection: this is called inflammatory bowel disease and has nothing to do with sex.
How is it transmitted?
Because the germs which cause proctitis live in the body's cells and surrounding fluids, they need close contact for transmission to occur. This includes oral, anal and genital contact. The risk may extend to fingering and sharing of sex toys. You can't catch the infection from towels, toilet seats or ordinary social contact - no matter how friendly! LGV has been linked to fisting. Most of those suffering with LGV have been HIV positive. LGV greatly increases the risk of passing on and catching HIV and Hepatitis C
What are the symptoms?
Symptoms for proctitis can be mild or totally absent, especially if you have had the problem for a long time. Symptoms to look out for are diarrhoea, mucus streaking of stools, anal pain and a sensation of needing to go to the toilet again shortly after your first visit. People with LGV report much more severe pain and bleeding.
How do I know if I have proctitis?
The test for proctitis involves the doctor gently looking at the appearance of the anal lining through a small instrument called a proctoscope. This is the best way to diagnose proctitis, but if you prefer you can simply have some swabs taken from the entrance to the anus - these can screen for gonorrhoea and chlamydia. LGV is diagnosed by typing the chlamydia if it is found but this can take a few weeks to be done.
What is the treatment?
This very much depends on the cause - and it's usually best if both you and your partner have treatment together. Usually this means a short course of antibiotics - take the complete course, even after the symptoms disappear. If we think you have LGV you need to take a longer course of up to 3 weeks. Until you and your partner have been back for check-ups to confirm that the problem has cleared, be sure you are having the right kind of low-risk sex.