Blood in Stool with Herpes Outbreak

Dear Dr. Tom:

I am a heterosexual 40 year old male living a mobile life as a professional travelling around Australia. I believe that I have had herpes 2 for about 10 years now which always manifests itself when I am under stress, as a pain either in my testicles or rectum before, within 2 days I get a blister on the end of my penis. This then disappears after about a week. Over the past three years I have created a fairly stress free life and have had no outbreaks. At the beginning of this month I decided on a lifestyle change and resigned from my job, and bingo, pain in my left testicle followed by the blister. This time however, for the past 30 hours there has been blood coming out when I pass stools and I am a bit concerned this may be unrelated to the herpes attack. Please can you advise whether you have ever come across a similar situation or do you think that it is most likely unrelated. Many thanks.

Dr. Tom’s Response:

Dear Clive:

I am reluctant to offer more than fundamental advice about the bleeding problem you have described. Herpetic proctitis (inflammation of rectum and anus) and anorectal herpes are known, although these conditions occur more commonly among homosexual men. The condition is more rare among heterosexuals. Bloody and mucoid stools are among the symptoms. The condition can be caused by HSV1 and HSV2 and can involve the outermost few inches of the intestinal tract to the anal sphincter or opening. My best advice is to seek the specific treatment of a gastroenterologist, a physician who specializes in diseases of the intestinal tract. Such a doctor would evaluate your previous history of herpes, stress, etc., and likely, will diagnostically examine your rectal area further. A family practice doctor may not be trained or equipped to do so. This may not be a pleasant situation to contemplate, but you owe it to yourself to take the best steps for your own good health. If your condition is not found to be due to a herpetic infection, such a visit may be especially important to you.


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