Herpes proctitis from anal fingering?

[hlth4ever]

I'm 34 male heterosexual married with no extramarital affairs.  About 2 months a go I went to a massage pallor. He massaged me and entered his fingers into my rectum.  I let him continue until his whole hand was inside, after which a few gentle thrusts felt unpleasant and I stopped him and left. I admit I do occasional self anal play but this was the only time with another person. Since then my rectal area has been in pain especially with bowel movements, especially afterwords. Pain is like burning, stabbing, and severe tightness. Sometimes pain radiates shortly into groin and upper thighs. GI doctor examined through colonoscopy and found nothing. Another Colon surgeon examined through a manual short anoscope and found nothing.  He suspects a chronic fissure although he didn't find it??? He prescribed GTN ointment and I've been on it for the last 2 weeks. It eliminated the spasm pain but not the rest.  I have no other complaint except this rectal pain that lasts hours a day if not the whole day. The thigh and groin pain is brief about 10 minutes and only occurs when the rectal pain is severe.

I'm worried that I might have been infected with herpes. Could I have herpetic proctitis although not showing up in the rectal examinations (missed by anoscope and colonoscopy)? Should I let an STD specialist examine my rectum? Should I pursue blood testing for herpes? Should I test for other STD and how?

[Edward W Hook, MD]

You have ordered the test, which as you know, I would recommend against. Having done that, you should look at the information it provides but, if it is positive, you should not assume that it answers your questions and concerns about your anal symptoms- no matter what the result, I am confident that your anal symptoms are not due to HSV.  EWH

[hlth4ever]

Thanks a lot for your kind reply doctor.  Actually this pain has been going on for the past 9 weeks.  There was a short time in between when I felt 90% better for 5 days but not longer.  Usually a bit more hard stool would make things so much worse again.

So I did a blood test Serology for HSV and Im still waiting for the results; should I go collect the result or is the possibility of a false positive so high that I might do more psychological damage to myself if it came back positive, and I should rather just forget the whole thing and not check for the results?  

[Edward W Hook, MD]

Welcome to the Forum. This problem is not herpes proctitis.  Testing for herpes or seeing an STD specialist would be a waste of time.  Hand to genital (or anal) transmission of herpes is nearly unheard of and without lesions on his hands and fingers of the masseuse, there is no risk,  Further, while you do not say how long these symptoms have gone on but it is clearly more than a few weeks, if this were herpes, the outbreak would not have lasted more than 2-3 weeks. Further, you have had two different physicians look into your anus and rectum and neither saw any lesions.  If this were herpes, lesions would have been seen.

I suspect that your continuing discomfort related to the insertion of the masseuse’s hand into your rectum or possibly hemorrhoids but this is not herpes.  I would not worry about this possibility at all, nor would I would about any STI from the encounter you have described.  

I hope my comments are helpful. EWH  

[hlth4ever]

I forgot to add that the masseur hand looked normal. I went to visit him again just to be sure his hands are having no lesions. Unfortunately he is an asian and didn't have a clue when I asked him about his STD status (doesn't speak English).