Rectal Symptoms in MSM

• STIs which can affect the anal canal/rectum (proctitis) include
  • Gonorrhoea
  • Chlamydia (LGV strains and classic strains)
  • Herpes simplex
  • Syphilis (may cause painful ulceration)
• Symptoms may include
  • mucopurulent anal discharge
  • rectal bleeding
  • pain
  • tenesmus
  • there may also be a history of GI symptoms e.g. diarrhoea (due to campylobacter, shigella..)
• On examination, there may be erythema, contact bleeding
• Take a history of presenting complaint; PMHx; SHx and full sexual history; Contact Hx
• Rectal swab for chlamydia and gonorrhoea +/- HSV PCR would be routine