Sexually Transmitted Diseases/Fissure

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Question
During tx
During tx  
Betore
Betore  
QUESTION: Mark,
It wouldn't let me respond to the last reply- it is an anus, and it was a fissure. I put preparation H on it and that helped immensely, but it started to look weird. Attached pictures of before and during treatment. Links are to general pictures- red rash burns? The area burns and itches. Sometimes I'm constipated. Sometimes I have diarrhea. Today I had diarrhea and that's when I noticed the red rash because the diarrhea burned.

http://i64.tinypic.com/2jcx5b4.jpg
Dark red area to the right of the picture.

http://i63.tinypic.com/2vjegav.jpg

And again.

Thanks
Leslie

ANSWER: Hi Again, Leslie,
Thanks for the updated photos. That is what it looked like-- a healing anal fissure.  The various areas of red are just different areas of healing with some inflammation. Besides the constipation and intermittent diarrhea, you didn't mention if you ever engaged in anal intercourse, which may also make the fissure worse-- as can the constipation and diarrhea, which may be irritating. Prevent the bowel irregularities-- eating high fiber meals, stay well hydrated, etc., avoid further irritation, and it should heal up in a few weeks.  Sometimes, sitting in a tub of comfortably hot tub of water can help with the healing.  

Good luck!
--mark


---------- FOLLOW-UP ----------

Red area
Red area  

Red area
Red area  
QUESTION: Hi mark-

I have engaged in anal intercourse, but it was in the last six months.

This is what it looks like today. Do the red areas look like anything, or are they simply areas inflamed hair follicles or glands?

They are the red places to the right and the left of the purple-reddish bumps.

Answer
Hi Again, Leslie,
Healing tissue will look weird while healing. A fissure can sometimes take a long time to heal, especially if you have some constipation which complicates the healing process. It is inflammation associated with the healing process. Remember what that your poop contains lots of germs that may interfere with and delay the healing process, especially if you have to strain, and if your stool is too hard and dry (which results in constipation).  

Good luck!
--mark  

Sexually Transmitted Diseases

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Mark P. Behar

Expertise

Almost any question or concern about gay men's health issues, sexually transmitted infections, abnormal Pap smears, anal cytology (anal "Pap smears"), etc. There is no such thing as “d/d free” or “clean” (free of infection), so why do so many of us deceive ourselves into thinking that some people are indeed totally free from a potentially infectious disease, like HIV, herpes, hepatitis, syphilis, chlamydia, warts, gonorrhea, etc., just because they say so? Clinical laboratory tests are not perfect, and having a “negative” or “nonreactive” test does not mean that a person is free from infection. Perhaps at the moment the test was taken, the person was uninfected; or, perhaps, the test wasn’t sensitive enough to detect presence of the infection. There is really no way that anyone can determine that they are truly “disease free,” and there are over a hundred of infectious conditions that can be spread without your knowing anything. Rather than trying to “pre-screen” or “serosort” a potential sex-mate with deceptive questions that are impossible to know by today’s technologies, a wiser option may be to consider everyone infected with something, and either use appropriate protective measures (“safer sex”), or accept the responsibility and consequences of possibly “catching” something from someone who’s hotter than expected (pun intended!). There is much research that supports the contention that an HIV positive person reliably taking HIV medications, and having an undetectable viral load, presents a lower risk for transmission of HIV than people who may think or say they are HIV negative, but are not. Food for thought!

Experience

Family Practice PA since 1981; Volunteer Clinician for Brady East STD (BESTD) Clinic, Milwaukee, since 1977; answered STD questions submitted to their web site. Professionally lectured at national and regional Physician Assistant and Nurse Practitioner conferences, and at national gay & lesbian health conferences on topics including HIV/AIDS, herpes, hepatitis, STDs, human papilloma virus (the cause of venereal warts), abnormal Pap smears, gay and lesbian health issues, among others.

Organizations
Co-Founder, Lesbian, Bisexual, & Gay Physician Assistant Caucus of the American Academy of Physician Assistants, Inc.; American Academy of Physician Assistants; Wisconsin Academy of Physician Assistants; National Co-Chair (2012-16), National Association of Black and White Men Together: A Gay, Multiracial Organization for All People (NABWMT)

Publications
Journal of the American Academy of Physician Assistants (JAPA) Q Visions, Quarterly Newsletter of the NABWMT

Education/Credentials
Bachelor's of Arts, 1972 (University of Wisconsin, Milwaukee, WI) Graduate Credits Experimental Psychology, 1972-75 (Tulane University, New Orleans, LA) Physician Assistant, Bachelor's of Science, 1981 (George Washington University, Washington, DC); Masters in Physician Assistant Studies, 2000 (University of Nebraska Medical Center, Omaha, NE)

Awards and Honors
Colposcopy Recognition Award (CRA), the American Association of Colposcopy and Cervical Pathology; Distinguished Fellow, Clinical Preceptor, American Academy of Physician Assistants; Fellow, Wisconsin Academy of Physician Assistants

Past/Present Clients
Brady East STD Clinic, Milwaukee, WI Milwaukee Health Services, Inc. (Martin Luther King Heritage Health Center), Dept. of Family Medicine and Early Intervention Program for HIV Infected Persons

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