Dr. Jiten Chowdhry

Anal herpes and anal warts are sexually transmitted diseases. These both diseases affect the genitals. As these are sexually transmitted diseases, these are transmitted through sexual contact.

Anal Herpes:

• It is an infection caused by herpes virus, which is caused by the sore or blisters formed around the anus. This infection is caused by the herpes simplex virus (HSV) type 1 or 2 viruses.
• The symptoms of anal herpes include red bumps or white blisters, itching and pain around the anal area, development of ulcer at the site of blisters, a coating that covers the ulcers ruptures or is bleeding, any change in the bowel habit.

Treatment

• Antiviral therapy is one of the primary treatment for anal herpes. The virus responsible mainly for herpes is herpes simplex virus type II. Antiviral medications are given to patients, these medicines fight the virus. The symptoms of herpes are reduced with this therapy.
• Regular use of antiviral medication is referred to as suppressive therapy. As the name suggests, people on suppressive therapy, reduce the risk of passing the infection to their sexual partner.
• In severe anal herpes, the doctor might give intravenous antiviral therapy to control the infection.However, the herpes virus cannot be cured as it is considered a lifelong infection. The virus stays in the nerve cells for lifelong and is inactive for long periods of time. It only outbreaks when it is triggered by an externalfactor such as illness, stress, or sun exposure.

Prevention
As anal herpes is transmitted through sexual contact, one can lower the risk of this disease. Safety measures can be used are:

• Wear a condom or use barrier protection during every sexual intercourse, including anal or oral sex.
• Reduce the number of sexual partners.
• If one maintains monogamy, the risk is minimal for transmitting anal herpes.
• One should abstain from sex altogether, if possible.

Anal Warts:
Anal warts are small warts that occur around the anus. Another name for anal wart is condyloma acuminate. In many cases, anal warts don’t cause any pain or discomfort. But, they cause irritation when they grow in size and might be itchy and/or bleed. However, if there are no symptoms seen, people suffering from anal wart might not even know that they have warts. Anal warts might occur only at a spot or even spread to different parts of the genitals such as buttocks, anus, and inner thighs over a period of time.

Symptoms
The anal warts are small bumps initially, a size of the head of a pin, which is not even noticed. However, as they grow, they can develop to a size of a cauliflower-likean appearance, when several warts are clustered together to form a huge lump. These warts are peach colored and the color may vary from yellow, light brown, or pink and it might even blend with the skin color. Usually the anal warts are without any pain or discomfort, however, other rare occurring symptoms are itching, discharge from the anus, or bleeding. Anal warts in women might appear on vagina, vulva, or at the cervix, whereas in men it can develop on penis, scrotum, groin area, or thighs.

Treatment
Topical medication can be used to treat anal warts, such as imiquimod, podofilox, podophyllum, etc. Another treatment of anal wart that depends upon the location and severity of the condition:

• Cryotherapy
• Electrocautery
• Laser treatments

Surgery can be recommended for larger warts that do not respond to medications. In case you have a concern or query you can always consult an expert & get answers to your questions!

Crohn’s disease is a chronic inflammatory disorder of GI or digestive tract. Crohn’s disease is most commonly affects the mucosal lining due to ulcerations of small and large intestines, but it can affect the entire digestive system. Crohn’s disease is usually related to another chronic inflammatory condition namely ulcerative colitis, which involves mainly colon. Crohn’s disease and ulcerative colitis are together referred to as inflammatory bowel disease. The symptoms include vomiting, abdominal pain, diarrhea, bloody diarrhea, fever, weight loss, anal fistulae, and perirectal abscesses. But, the symptoms are mostly dependent on the location, extent,and severity of the inflammation.

Subtypes of Crohn’s disease are:

• Crohn’s colitis – Inflammation of the colon. The common symptoms are abdominal pain and bloody diarrhea. However, anal fistulae and perirectal abscesses can also occur.
• Crohn’s enteritis – Inflammation of small intestines. Mainly jejunum (second part) or ileum (third part). The common symptoms are abdominal pain and diarrhea. In this obstruction of small intestines can also occur.
• Crohn’s terminal ileitis – Inflammation of the part of the small intestine which is closest to the colon, i.e. ileum (third or terminal part of small intestine). Similar to colitis and enteritis, the common symptoms are abdominal pain and diarrhea.
• Crohn’s entero-colitis and ileocolitis – Inflammation involving both small intestine and colon. The symptoms include abdominal pain and bloody diarrhea. Obstruction of the small intestine can also occur.

Causes of Crohn’s Disease
The cause of the disease is still not known. However, the researchers report that it is due to the abnormal response of the immune system. The uncontrolled inflammation which is associated with Crohn’s disease may be caused by food or bacterial intestines or due to the lining of the bowel.

Diagnosis
There are various diagnostic procedures and laboratory tests by which Crohn’s disease can be distinguished from other GI tract disease such as ulcerative colitis. A gastroenterologist can perform a sigmoidoscopy or colonoscopy to get bowel tissue for analysis or upper endoscopy can be done to study esophagus, stomach,and duodenum (first part of small intestine). To study in detail of small intestine, capsule endoscopy can be done, which is done by using a small, pill-sized camera which is swallowed. Other tests that can be suggested by your doctor are:

• Blood tests can be done. High white blood cell indicates inflammation and low red blood cells indicates a sign of anemia due to blood loss.
• Stool examination can be done to rule out any infection that can occur due to diarrhea.
• Special x-rays, namely CT scan or MRI can be performed of both upper and lower GI tract in order to confirm the location of the inflammation.

Treatment
Although there is no cure for Crohn’s disease, however, one can lead normal lives. Crohn’s disease is normally treated with medications. These include:

• Anti-inflammatory drugs, namely, salicylates. Side effects of these drugs are gastrointestinal upset, nausea, rash, headache, or diarrhea.
• Corticosteroids, again type of anti-inflammatory drugs, but this is more powerful. The side effects are seen if these drugs are consumed for long periods of time, mainly, thinning of bone, muscle loss, skin problems, and increased risk of infections.
• Antibiotics can be given such as ciprofloxacin, metronidazole,and others. The side effects include nausea, tingling or numbness of feet and hands.
• Antidiarrheal drugs

Risks
Along with Crohn’s disease, you are likely to develop other health problems such as colon cancer, lymphoma, deep vein thrombosis or pulmonary embolism, or psoriatic arthritis.
Thus, with this information, you can with the help of your doctor can work out your plan to avoid problems and possible complications. In case you have a concern or query you can always consult an expert & get answers to your questions!