Dr. Dick Circles your Anus: Some of the more common anal health problems among gay, bi, and trans guys.
Last issue, Dr. Dick answered a reader's question about anal pain. Now, Dr. Dick will take you on a guided galactic tour of anal health concerns.
Gonorrhea, Chlamydia, Herpes, and Syphilis.
These STDs are common among gay and bisexual men who have anal sex without condoms. These STDs don't always have symptoms. If you have anal sex without condoms, it's best to get tested regularly for all STDs every 3 to 6 months. (Call 206-205-7837 to get a test.)
To find out if you have an STD, the doctor or clinician may insert a finger or maybe a small scope to look around. Most likely, she or he will collect any pus or discharge on a tiny swab. The swab will then be dabbed on a "culture" plate or on a slide to see if any bacteria can be identified. If you've had unprotected anal sex recently, the doctor may prescribe antibiotics to get rid of any possible infections. Make sure to take all the medication your doctor prescribes - even if the symptoms clear up! That way you won't develop a "drug resistant" STD.
Sometimes gonorrhea and chlamydia symptoms go away on their own, but the infection will still be present. Syphilis generally causes no signs or symptoms in the rectum. You can have it without ever knowing it. Even if you don't have symptoms or if symptoms go away, untreated STDs can cause permanent damage to your body.
Anal Warts.
This STD is caused by human papilloma virus (HPV). Warts are small fleshy growths on the outside or just inside the butt. Not everyone who has the "wart virus" will develop warts. But even guys with HPV who don't have "visible" warts can pass the virus on to their sex partners. For example, a partner with HPV can pass the virus on to you if his genitals (penis, anus, and perineum) come into contact with your genitals. Using condoms will reduce your chances of getting warts. But
condoms won't eliminate all the risk because condoms don't cover all the areas where warts can be present.
Anal warts can be removed several ways. They can be frozen off with liquid nitrogen or burned off using "electrocautery." Topical medicines can also be used. But only trained medical staff should do these treatments. Don't try to treat yourself. And never use over-the-counter wart treatments on genital warts. If you are HIV positive or your immune system is compromised for other reasons, you may be more likely to develop anal or penile warts. HPV has also been linked to anal cancer among gay and bisexual men. Anal pap smears are being studied to see if they can detect early forms of cancer in the rectum. So, if you have anal sex, talk with your doctor. You can also call the STD Hotline (206) 205-7837 and ask about enrolling in clinical studies for the anal pap smear.
Anal Fissures.
These are small tears or rips in the surface of the anus. The lining of your ass is moist tissue that can be damaged easily. Fucking, fingerplay, and using toys or dildos can cause small tears. You may notice a small amount of blood on the surface of your shit after a tear occurs, but many people don't feel any symptoms. Tears will generally heal by themselves, but can easily be reopened and enlarged. These tears can also become infected - after all, the ass isn't the cleanest part of your body! When an infection like this occurs, it can be really bad news. Sometimes a painful peri-rectal abscess may develop. Other times, the infection can spread into your body. If this occurs, a doctor will prescribe antibiotics and may need to hospitalize you. Usually, small anal tears will heal over time if you stop having anal sex for a while. Large anal fissures and extensive infections may require hospitalization & surgery to correct.
Hemorrhoids.
There are two kinds of people in the world: those who have hemorrhoids, and those who will get them. Hemorrhoids are enlarged veins. They can occur on the outside of the rectum or just inside the anus. These enlarged veins can be painful or just itchy. You will usually be able to feel an enlarged vein or lump with your finger either outside or just inside the anus. Hemorrhoids can become red and swollen if you strain when you take a shit. A stool softener like Colace can be helpful, to limit further irritation. Hemorrhoids can become red and swollen during anal intercourse. This can also happen with other types of ass play like fingering, fisting, and using sex toys or dildos.
Most hemorrhoids are easily treated with creams, lotions and suppositories from your local pharmacy or grocery store. Sitting in hot water in the bathtub can also help. These treatments may decrease the itching, swelling and pain. For some individuals, over-the-counter medications may not be effective in reducing symptoms. If this is the case, a doctor or clinician may prescribe a stronger medication to assist in the healing process. Some guys will need to have hemorrhoids banded or removed surgically. Surgery is used for those with recurring problems and is a quick but somewhat painful procedure. Until hemorrhoids have had a chance to heal, it's a good idea to avoid anal sex.
So guys- for Dr. Dick's sake- Get your butt examined! And don't forget to wear your rubber space suit when exploring Uranus or other heavenly bodies!