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Proctitis in homosexual men. A diagnostic problem.

A McMillan, H M Gilmour, K Slatford

    The British Journal of Venereal Diseases
    |August 1, 1983
    PubMed
    Summary
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    Clinical rectal examinations and gastrointestinal symptoms did not reliably diagnose proctitis in men. Cytological examination aided in detecting infective proctitis but not chronic proctitis.

    Area of Science:

    • Gastroenterology
    • Proctology
    • Medical Diagnostics

    Background:

    • Proctitis diagnosis in men with a history of anal intercourse can be challenging.
    • Clinical features, sigmoidoscopy, and cytology are potential diagnostic tools.

    Purpose of the Study:

    • To correlate clinical features, mucosal cytology, and rectal histology in men with a history of anal intercourse.
    • To evaluate the diagnostic utility of sigmoidoscopy and cytology for different types of proctitis.

    Main Methods:

    • Study included 176 men with histories of anal intercourse.
    • Evaluated clinical features, gastrointestinal symptoms, sigmoidoscopy findings, mucosal cytology, and rectal histology.
    • Compared findings between patients with and without proctitis, and between infective and chronic proctitis.

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    Main Results:

    • Gastrointestinal symptoms did not differentiate proctitis presence.
    • Sigmoidoscopy was normal in all men with normal histology.
    • Macroscopic abnormalities were seen in most infective proctitis cases, but sigmoidoscopy was often normal in chronic proctitis.
    • Cytology was useful for infective proctitis but not chronic proctitis.

    Conclusions:

    • Clinical assessment and sigmoidoscopy have limitations in diagnosing proctitis, especially chronic forms.
    • Cytological examination is a valuable adjunct for diagnosing infective proctitis.