Anal Discomfort - concerned about Herpes

[Stan Cooke]

Hi, I very stupidly had unprotected sex about 11 days ago and have been very worried about the possibility of Herpes.

  I have developed no symptoms on my penis or scrotum but am experiencing discomfort just inside my anus.  The area around the opening, just inside, looks almost red raw although it is not painful or itchy and does not sting I feel the discomfort when I sit down as if the area is indeed raw.  From what I can see there are and have been no blisters or pimples forming just an area of redness just inside the opening of the anus.  Again, this area does not hurt when I pass stools or bleed whatsoever.

Also, the bone at the very base of my back, just above my anus is very tender to the touch and can ache slightly and I wonder if this could in any way be related.  

I'd be very greatful if you could advise me as to the most likely cause of this discomfort as I am worried sick about the possibilities of what this could be.

Many Thanks

Stan

[H. Hunter Handsfield, M.D.]

Your symptoms sound like you have proctitis (rectal inflammation), which is common in gay men and most commonly is due to gonorrhea, chlamydia, or herpes.  But you say nothing about the nature of your sexual exposure; sexually acquired proctitis requires being the receptive partner (“bottom”) in anal sex, although sometimes it occurs in women without anal intercourse.  If you did not have receptive anal sex, then your symptoms probably aren’t due to the sexual exposure you describe.  Non-sexually acquired proctitis can occasionally accompany other gastrointestinal infections, or can be a sign of inflammatory bowel disease, such as ulcerative colitis or Crohn’s disease.

In either case, you should see a health care provider, preferably one who understands proctitis and how to diagnose it.  Your local health department STD clinic is a good bet, especially if you were a bottom in that exposure. Otherwise, a primary care provider or a gastroenterologist would be fine.

PS:  After composing the above off-line, I saw your follow-up comment.  Unless there was trauma to your anal area during sex--e.g., vigorous manual stimulation--I don't see how your symptoms can be related to the sexual exposure you describe.

Good luck--  HHH, MD

[Stan Cooke]

I should add that I am hetrosexual and sex I had was vaginal intercourse.