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Causes And Treatment Of Anal Gonorrhea

Anal gonorrhea
Submitted and Medically Reviewed By: Dr. Mavra Farrukh

Overview 

STDs can affect multiple regions of your body, including your vagina, penis, mouth and your anus as well. Many people don’t expect to get STDs such as anal gonorrhea. It’s easy to ignore the signs you may have contracted an infection. Gonorrhea can cause discomfort or may be asymptomatic. Meaning that you could have the infection and spread it unknowingly. 

What is anal gonorrhea?

This STD is caused by the bacteria called Neisseria gonorrhoeae. The bacterium causing gonorrhea thrives in moist environments making the mucous membranes in the urethra and parts of the reproductive tract a perfect place to reside and cause infection. 

Although spread through sex, a man doesn’t necessarily have to ejaculate to pass it on to their partner.

Gonorrhea can be passed on through:

  • Anal intercourse
  • Oral intercourse (both giving and receiving)
  • Vaginal/genital intercourse

You may also get the infection just from touching an infected area of another person. This includes coming in contact with the vagina, penis, mouth, or anus of someone with gonorrhea. 

Women who have gonorrhea at the time of delivery can pass it to their baby during vaginal delivery. 

You can’t get gonorrhea by touching objects like toilet seats as the bacteria don’t survive for long outside the body.

Anal Gonorrhea Symptoms

Symptoms of gonorrhea depend on which part of the body is affected. Symptoms vary in males and females, and many individuals do not experience any symptoms. Being asymptomatic leads to the transmission of infection as the infection remains undiagnosed. The throat, urethra and rectum can affect both men and women. Regions affected specifically in women include the cervix, uterus, fallopian tubes, and ovaries.

In comparison, gonorrhea in men can affect the epididymis and prostate. Rectal gonorrhea occurs if you have anal sex with a person who has a gonococcal infection. Infection of the anus can also develop amongst men who have sex with other men. It is possible to spread the infection to your anus from another region.

An example is when you wipe after going to the bathroom, you can infect your anus if you have genital gonorrhea. Gonorrhea on the anus may produce no symptoms. Gonorrhea anal discharge is a symptom that you may experience but ignore. You may also experience symptoms that are non-specific to the infection; hence, rectal gonorrhea symptoms are commonly overlooked, considering them to be caused by other conditions. Some symptoms of anal gonorrhea include: 

  • Itching around your anus 
  • Pain while passing stool
  • Discharge from the rectum
  • Constipation
  • Bleeding while passing stool

Oral gonorrhea may result in a sore throat, but mainly throat infections cause no symptoms at all.

Other symptoms of gonorrhea in women can include:

  • Vaginal itching or abnormal vaginal discharge
  • Bleeding or spotting in between periods
  • Pain or discomfort during urination
  • Pain during intercourse

Some common symptoms of gonorrhea in men include:

  • Pain or discomfort with urination
  • An abnormal penile discharge 
  • Pain and swelling in one testicle or both testicles
  • Urethral itch
Anal discharge or itching can be a sign of gonorrhea. You can get tested and treated by a doctor.

How is anal gonorrhea transmitted?

Gonorrhoea is spread during oral, vaginal or anal sex. It can be passed on by sharing unwashed sex toys or reusing the same condoms.

It may be possible to spread gonorrhoea on fingers when you touch an infected part of the body and then touch other parts of your or someone else’s body.

Common Risk Factors for Gonorrhea

  • Sexual contact with a person having the infection
  • Having unprotected sex with multiple partners
  • Having sex with a new partner without using protection
  • Unprotected sex with someone who is from an area where gonorrhea is prevalent 
  • Sexually active people usually under 25 years of age
  • History of a previous infection
  • Being birthed by a person who has gonorrhea
  • Unprotected anal intercourse in bisexual, gay and other men who have sex with men 

How is anal gonorrhea diagnosed?

Any sexually active person has a chance of contracting gonorrhea. If you are experiencing symptoms such as vaginal or penile discharge or gonorrhoea rectal discharge, burning during urination, sores, or rash, it is best to avoid intercourse and get tested. Furthermore, anyone with an oral, anal, or vaginal sex partner recently diagnosed with an STD should consult a doctor for testing. 

Individuals should be tested for gonorrhea even if they are symptomless and their sex partner has been diagnosed with gonorrhea. Anyone sexually active should discuss their risk factors with their doctor. People who have gonorrhea should also be tested for other STDs.

Some anal gonorrhea symptoms include mucus in stool or may indicate gonorrhea on the butt. Therefore CDC recommends yearly screening for all sexually active women younger than 25 years and above who have multiple sex partners or a sex partner with a sexually transmitted infection.

Your doctor will ask about your symptoms and sexual history. A urine test can often diagnose gonorrhea.

The doctor may also:

  • Carry out a pelvic exam and take a sample of cervical fluid/swab 
  • Take a sample of fluid from the penis.
  • Do a throat swab for culture.
  • Take an anal swab for culture, also known as a rectal gonorrhea test.

Your doctor will help determine which kind of test is best for your situation. The results may take a few days. Chlamydia, another STD, can often occur at the same time as gonorrhea. That is why a doctor often tests the individual for both infections. 

Treatment of Anal Gonorrhea 

Antibiotics are the mainstay treatment for anal gonorrhea. 

For uncomplicated infections:

  • Intramuscular Ceftriaxone 500 mg in a single dose for persons weighing <150 kg
  • For people weighing ≥150 kg, 1 g ceftriaxone is the recommended dosage.

If there is a possibility of chlamydial infection, treatment involves:

Alternative Regimens

If a person has a cephalosporin allergy:

  • Single dose of Gentamicin 240 mg Intramuscular

PLUS

  • Single dose of azithromycin 2 g orally 

If ceftriaxone administration is unavailable:

  • Cefixime 800 mg orally once only

Prevention of Anal Gonorrhea

Some measures that may help prevent gonorrhea include:

  • Use protection such as a condom every time you have sex.
  • Avoid sex if you or your sexual partner has symptoms such as abnormal or burning with urination or discharge.
  • Get regular screening for sexually transmitted infections even if you have no symptoms, especially if you have more than one partner or a new partner.
  • Consult your doctor if you have any symptoms of gonorrhea or another infection, and get tested without delay. 
Anal discharge or itching can be a sign of gonorrhea. You can get tested and treated by a doctor.

Why do they call gonorrhea “the clap”?

This question doesn’t have a definite answer, but gonorrhea has been around for a long time. There are a few theories that revolve around this term. One such theory identifies “the clap” as a derivative of ‘Les clapiers’ a French word translating to rabbit huts and eluding to the tiny homes that prostitutes inhabited during the 1500s. “The clap” is sometimes used to refer to the medieval method that involved clapping an object on a person’s penis to remove discharge produced from the infection. Moreover, the term was used centuries ago to describe the symptom of gonorrhea, a clapping sensation some people experienced while peeing.

Other Types of Anal STDs

There are many types of anal STDs—some present with symptoms that are specific and easy to identify. 

Herpes

One such STD that can infect the anus is herpes. It is a prevalent infection caused by either the herpes simplex 1 or herpes simplex 2 virus. Sometimes herpes is asymptomatic; if you get anal herpes, you may experience symptoms such as painful blisters, sores, tingling and itching.

HPV

Another anal infection is human papillomavirus. It is a commonly sexually transmitted disease. According to the Centres for Disease Control and Prevention, one in four Americans, or around 80 million people, have HPV. HPV can cause anal warts or anal warts that look like little cauliflower pieces. 

It can also result in cervical, mouth, vaginal, penile and oral cancers,

Anal chlamydia and gonorrhea

Chlamydia and gonorrhea are not actually rare. Chlamydia is among the commonly reported STDs in the United States, especially in women 25 and under, and gonorrhea is also prominent in the same age group. Although these STDs often present without symptoms, some common signs of having one include pain or burning while urinating, abnormal vaginal or penile discharge and vaginal bleeding between periods.

Rectal chlamydia and gonorrhea present with different symptoms. The signs aren’t as well known and may include persistent, watery diarrhoea, a typical symptom of a stomach bug. Other symptoms include rectal pain, anal itching anal soreness, mucus discharge and bleeding. The rectal discharge can be yellow or grey and carries a foul odour. Although, anal infections are most prevalent in men who have sex with other men. Anyone having anal sex is susceptible.

When to go to the Hospital

If left untreated, gonorrhea can result in more serious medical conditions. The infection may spread through the bloodstream. It can affect mucous membranes throughout the body. Symptoms of more severe disease mainly include joint pain and a skin rash. Complications of gonorrhea can also include meningitis (inflammation of the brain) or perihepatitis (inflammation of the capsule surrounding the liver). Furthermore, it can cause PID (pelvic inflammatory disease) in women. That presents with a fever, pelvic pain, and vaginal discharge and can lead to infertility due to scarring of fallopian tubes. 

In men, it can lead to epididymitis(inflammation of the testicles and can eventually contribute to infertility as well. Fever, abnormal penile discharge, and painful urination may indicate inflammation of the testicles.

If you are experiencing such symptoms, you need to visit the emergency department immediately for treatment with IV antibiotics. 

When to Consult a Doctor 

Recognising the signs of gonorrhea and staying up to date with the facts about STDs will help you come up with the best plan to take care of your health and make a decision accordingly. For questions regarding gonorrhea, testing or treatment, consult with our doctor at Your Doctors.Online and receive the best possible care.  

Anal discharge or itching can be a sign of gonorrhea. You can get tested and treated by a doctor.

FAQs About Anal Gonorrhea Answered by Your Doctors Online Team

How do you get anal gonorrhea? 

Gonorrhea can be passed on through:
Anal intercourse
Oral intercourse (both giving and receiving)
Vaginal/genital intercourse
You can get that cause infection just from touching an infected area on another person. This includes coming in contact with the vagina, penis, mouth, or anus of someone with gonorrhea. 

What permanent damage can gonorrhea cause in men?

Gonorrhea may cause epididymitis or a prostate gland infection, which can eventually cause infertility in men. 

Where to get an anal STI test?

​​A rectal swab is required to test for gonorrhoea. You can get a home test kit or follow up with your health care provider for testing. You can also connect with our doctor online to get a lab requisition.

Can you get an std from poop?

Rimming, also known as oral stimulation of the anus, is considered a sexual behaviour that exposes people to infections that can be transmitted through the fecal-oral route.Some infections transmitted by the fecal-oral route include:
Herpes
Gonorrhea
HPV 

What std can cause an anal fissure?

The usual cause of anal fissure is constipation or straining while passing stool. Another cause is inflammation of the rectum due to Crohn’s disease. STDs resulting in anal fissures are syphilis, gonorrhea, herpes simplex virus, and HIV.

Can you get gonorrhea without having sex?

Gonorrhea can be spread through touch as well. You can get that cause infection just from touching an infected area on another person.

Doctors Treating this Issue
dr asim cheema

Dr. Asim Cheema

Internal Medicine

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