Infectious proctitis: what every gastroenterologist needs to know

Coelho, Rosa; Ribeiro, Tiago; Abreu, Natacha; Gonçalves, Regina; Macedo, Guilherme

doi:10.20524/aog.2023.0799

Cited by 2 publications

(9 citation statements)

References 47 publications

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“…STI can trigger or mimic an IBD flare and must be considered in the differential diagnosis of refractory proctitis. 19 We found that the more experienced responders were more likely to have encountered such cases in the past, but even they do not routinely collect samples for STI detection in relevant cases. Current literature provides specific recommendations that should be provided to patients with IBD, including selection of appropriate contraceptives, 26 STI prevention, and safe anal intercourse practice.…”

Section: Discussionmentioning

confidence: 81%

“…Nineteen responders (37%) reported that they had initiated a conversation regarding sexual activity with patients STIs are among the differential diagnoses for refractory proctitis. 19 Although 8 physicians (15%) had encountered proctitis secondary to STIs among adolescents with IBD, all PedGI responders with one exception responded that they do not routinely obtain rectal cultures to diagnose it. The question regarding STIs testing was included in the survey under the refractory proctitis-related set of questions but phrased in a general manner; therefore, the proportion of physicians taking a culture may be underestimated.…”

Section: Common Practicementioning

confidence: 99%

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Sexual health in adolescents with inflammatory bowel disease – The paediatric gastroenterologists' point of view

Anafy,

Cohen,

Matar

et al. 2024

Acta Paediatrica

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AimAlthough sexual health (SH) impairment and sexually transmitted infections (STI) are occasionally encountered in patients with inflammatory bowel disease (IBD), paediatric gastroenterologists (PedGI) do not often discuss these issues. Literature about SH in the paediatric IBD population is limited. We aimed to assess PedGI knowledge and common practice related to sexual advice and STI workups in patients with IBD.MethodsA questionnaire comprising 25 questions addressing sexual activity in youth, SH, recommendations, and workup for STI in adolescents with IBD was sent to all registered PedGI in Israel.ResultsFifty‐two physicians completed the questionnaire (27 males,52%). Only 50% correctly predicted the mean age that Israeli youth start practicing sex. Seventy‐five per cent responded that providers should discuss sexual activity with their patients, but only 19% do so, most often in response to a patient's query. Ninety six percent answered that they do not have enough knowledge about SH in IBD. Finally, only 2% obtain rectal swabs for STI in patients with refractory proctitis.ConclusionSexual issues and recommendations are not routinely discussed by the majority of PedGI in paediatric IBD clinics. Providers should obtain more knowledge in the field and initiate discussion of these issues with adolescent patients with IBD.

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Section: Discussionmentioning

confidence: 81%

Section: Common Practicementioning

confidence: 99%

Sexual health in adolescents with inflammatory bowel disease – The paediatric gastroenterologists' point of view

Anafy,

Cohen,

Matar

et al. 2024

Acta Paediatrica

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“…Coinfection with multiple agents is not uncommon [17]. Table 2 describes the diagnostic work-up that should be carried out if an infectious proctitis is suspected.…”

Section: Infectious Proctitismentioning

confidence: 99%

“…Rectal biopsies, especially if positive for C. trachomatis, are crucial to rule out lymphogranuloma venereum. Long-standing lymphogranuloma venereum can mimic Crohn's disease, necessitating total colonoscopy in addition to imaging studies for accurate diagnosis [17].…”

Section: Infectious Proctitismentioning

confidence: 99%

“…Therefore, a thorough clinical history and physical examination are important to suggest a possible infectious proctitis. A recent traveling history, unprotected receptive anal sex, fever, lymphadenopathy, or anogenital findings in the physical examination could rise the clinical suspicion of infectious proctitis [17]. Unfortunately, not rarely the symptoms are scarce or unspecific and the endoscopic presentation is similar between the entities, with the diagnosis of infectious proctitis being only obtained in patients with IBD clinical suspicion not responding to specific medical therapies like messalazine in ulcerous proctitis [19].…”

Section: Inflammatory Bowel Diseasementioning

confidence: 99%

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Gastroenterology healthcare in LGBTQ+ individuals

Coelho,

Gonçalves,

Mendes

et al. 2024

European Journal of Gastroenterology &Amp; Hepatology

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Lesbian, gay, bisexual, transgender, queer, or questioning individuals, as well as those with another diverse identity (LGBTQ+), present specific nuances in healthcare that physicians must consider in clinical practice. Particularly, gastroenterologists are nowadays facing different issues in several fields regarding LGBTQ+ healthcare, such as endoscopy, inflammatory bowel disease, hepatology, and proctology. In this study, the authors provide a practice-oriented and up-to-date review reinforcing the importance of some of the most prevalent pathologies associated with sexuality that gastroenterologists may encounter in their clinical practice. In terms of endoscopy, authors describe the endoscopic findings related to human papillomavirus (HPV) infection: the esophageal squamous papilloma and cell carcinoma; also highlight the importance of retroflexion maneuver during a routine colonoscopy that allows detection of anal intraepithelial neoplasia lesions that can be anal cancer precursors. Regarding inflammatory bowel disease, some considerations are made about the differential diagnosis with infectious proctitis, and the topic of the risk of anal cancer due to HPV infection, in this specific population, is also addressed. Considering hepatology, the authors review the most important issues related to hepatotropic sexually transmitted infections. The authors also make some comments regarding the possibility of drug-induced liver injury in gender-affirming hormone therapy and pre-exposure prophylaxis for HIV prevention. Finally, considering the proctology field, an up-to-date review is performed regarding anal cancer screening, HPV infection and related diseases, and infectious proctitis management.

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Infectious proctitis: what every gastroenterologist needs to know

Cited by 2 publications

References 47 publications

Sexual health in adolescents with inflammatory bowel disease – The paediatric gastroenterologists' point of view

Sexual health in adolescents with inflammatory bowel disease – The paediatric gastroenterologists' point of view

Gastroenterology healthcare in LGBTQ+ individuals

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