Sexually transmitted disease-related gastrointestinal infection

　　Pathogens causing sexually transmitted diseases include Neisseria gonorrhoeae, Treponema pallidum, HIV (Human Immunodeficiency Virus), hepatitis virus, mycoplasma, and chlamydia, etc. Female rectal gonorrhea can originate from the patient's own urogenital tract, and can be infected through enema or rectal thermometer, or directly transmitted from the vagina. Gastrointestinal symptoms caused by Treponema pallidum, HIV, and hepatitis virus are mainly secondary to the sexually transmitted disease itself. Oral-anal contactors can mutually transmit Salmonella, Shigella, intestinal amebiasis, Streptococcus, or Campylobacter jejuni, etc., causing gastrointestinal symptoms.

　　In addition to their clinical manifestations, sexually transmitted gastrointestinal infections can also cause other diseases. Bacterial infections in the gastrointestinal tract can cause severe malabsorption. A few can induce sepsis.

　　Sexually transmitted gastrointestinal infections may present with different clinical manifestations depending on the pathogen. The main manifestations include the following several types:

　　1. Gastrointestinal manifestations of AIDS

　　Diarrhea is one of the main manifestations of AIDS.

　　2. Gastrointestinal manifestations of gonorrhea

　　Rectal gonorrhea has no specific symptoms, and some patients may have rectal burning sensation, anal itching, hematochezia, or mucous stools, or even diarrhea symptoms.

　　3. Gastrointestinal manifestations of syphilis

　　Subungal ulcers can be seen in the anal-rectum. After 2-4 weeks, the primary lesion can heal spontaneously. Subsequently, secondary syphilis may occur 3-4 weeks to 3 months later, with the gastric mucosa widely involved. Patients may clinically present with abdominal pain, non-nausea-induced vomiting, and non-anorexic weight loss.

　　4. Gastrointestinal manifestations of viral infections

　　In viral infections, the most common infections are herpes simplex virus, cytomegalovirus, and hepatitis virus infections. Type 2 herpes simplex virus mainly affects the anal area, which can manifest as anal-rectal pain with discharge, or may also appear with diarrhea or constipation. Sexual contact that comes into contact with the intestinal mucosal surface can transmit a variety of viruses. Hepatitis A is more prevalent in male homosexuals, and hepatitis B and C can also be transmitted through various sexual behaviors.

　　The prevention of sexually transmitted gastrointestinal infections mainly focuses on the prevention of the primary disease. It is necessary to block the blood-borne transmission route of sexually transmitted diseases, strictly prohibit high-risk groups from donating blood. Popularize knowledge of sexually transmitted diseases, eliminate unclean sexual life. Actively develop effective vaccines, which will play an important role in preventing the transmission of sexually transmitted diseases.

　　Clinical suspicion of infectious diarrhea transmitted sexually requires examination of fecal routine, parasites, and fecal culture. For patients with proctitis, anal secretions or rectal镜sampling should be taken for the isolation and culture of gonococci, herpes simplex virus, mycoplasma, or chlamydia. Serological tests can be used for the diagnosis of syphilis, chlamydia, and viral hepatitis.

　　Due to the close relationship between the diet and prognosis of gastrointestinal infections related to sexually transmitted diseases, a reasonable diet is particularly important for patients. In terms of diet, the following points should be noted:

　　1. Maintain regular and normal eating habits. Three meals a day should be on time and in proper quantities to avoid affecting the normal operation of the stomach.

　　2. Daily diet should be easy to digest and high in fiber, such as steamed buns, potatoes, pumpkins, bananas, papayas, etc.

　　3. Avoid刺激性 food, such as strong alcohol, coffee, strong tea, carbonated drinks, etc.

　　The treatment of sexually transmitted disease-related gastrointestinal infections is mainly for the treatment of the primary disease. When treating, different treatment methods should be adopted according to different causes. Therefore, the main treatment methods for this disease are as follows.

　　I. Treatment of AIDS

　　1. Antiviral treatment: For the treatment of AIDS, mainly zidovudine, didanosine, stavudine, lamivudine and other drugs are used.

　　2. Antimicrobial treatment: For Salmonella and Shigella infections, mainly ciprofloxacin, ofloxacin, ceftriaxone (ceftriaxone) are used for treatment; for Campylobacter jejuni infection, mainly erythromycin is used for treatment; for Giardia lamblia infection, mainly metronidazole is used for treatment; for Cryptosporidium infection, mainly paromomycin or azithromycin is used for treatment.

　　3. Symptomatic and supportive treatment: If the patient has diarrhea and dehydration, parenteral nutrition and electrolyte supplementation should be provided. If the stool is not formed, one to two bags of attapulgite (Simetade) can be taken 3 times a day. Attapulgite (Simetade) should be taken 90 minutes after other drugs.

　　II. Treatment of Gonorrhea

　　Oral, pharyngeal, and rectal gonorrhea often produce drug resistance to antibiotics. Generally, ceftriaxone 250mg can be taken orally 3 times a day for a course of 1 week.

　　III. Treatment of Syphilis

　　Syphilis is divided into latent syphilis, primary syphilis, secondary syphilis, and tertiary syphilis. Different stages require different treatment methods, and clinical attention should be paid to the distinction of medication.

　　IV. Treatment of Chlamydia

　　Acute chlamydial infection can be treated with azithromycin or ofloxacin. For pregnant women, erythromycin or ampicillin is recommended.

　　V. Treatment of Herpes Simplex

　　Anal herpes is often secondary infection, and the time required for cure is longer than that of the primary lesion. The commonly used drug is acyclovir. Severe patients may require hospitalization.