Intestinal infections previously thought to be gastroenteritis or food poisoning may be linked to sexual activity, posing a new public health issue, a physician at National Cheng Kung University Hospital said today.
Recent studies in Taiwan show that bacteria and parasites that cause intestinal infections such as Shigella; Giardia; Chlamydia trachomatis, which causes lymphogranuloma venereum (LGV); and Entamoeba can be sexually transmitted among certain groups, infectious disease specialist Tsai Chin-hsiang (蔡進相) said.
This type of infection is more common among those with multiple sexual partners, men who have sex with men, HIV-positive people and those with a history of sexually transmitted infections, Tsai said.
Photo courtesy of National Cheng Kung University Hospital via CNA
Initial symptoms may be mild, causing people to unknowingly become carriers and increasing the risk of transmission, he added.
Those who have diarrhea, bloody stools, tenesmus, anal pain, discharge or discomfort for more than three days after anal intercourse should see a doctor as soon as possible, Tsai said.
Since 2015, cases of Shigella infection in Taiwan have been concentrated among men with no travel history and are strongly associated with sexual activity, Tsai said.
Symptoms include bloody stools, fever, abdominal pain and tenesmus, meaning a frequent urge to use the restroom, he said.
Drug-resistant Shigella has already appeared in Taiwan, so empirical treatment should be used cautiously, as improper use of antibiotics may be ineffective and further increase resistance, the doctor said.
From 2020 to 2023, sexually transmitted disease monitoring at the hospital confirmed that rectal LGV is spreading in Taiwan for the first time, Tsai said.
Symptoms may be similar to ulcerative colitis, and an endoscopy may show non-specific ulcers, he said.
If left untreated, the infection can lead to chronic rectal inflammation, anal stenosis or fistulas, he added.
The key to treatment is accurate diagnosis, which can include stool tests and sexually transmitted infection screenings, Tsai said.
The doctor cautioned against using anti-diarrhea drugs, as they can cause germs to stay in the body longer.
Long-term use of proton pump inhibitors may make it easier for intestinal pathogens to survive and for people to continue carrying them, he said.
Proper testing, appropriate treatment and clear risk communication can help patients recover and prevent pathogens from becoming more resistant to drugs, he added.
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