Colorectal LLM Wiki

Browse
Home / Sources / ASCRS Ch18 - Sexually Transmitted Infections of the Colon and Rectum
Source created 2026-08-24 · updated 2026-08-24
colorectalsexually-transmitted-infectionanorectalchlamydiagonorrheasyphilisherpes-simplexhpv-condylomahivtextbookreferenceASCRS

ASCRS Ch18 — Sexually Transmitted Infections of the Colon and Rectum

Citation: Cowan M, Schlussel AT. "Sexually Transmitted Infections of the Colon and Rectum." In: Steele SR, et al. (eds.), The ASCRS Textbook of Colon and Rectal Surgery, 4th ed. Springer Nature Switzerland AG; 2022. pp. 323–342 (PDF pp. 330–349 of the combined textbook file). Source file: raw/ASCRS Textbook 4th Ed.pdf (full 1,198-page textbook; cite by page range within the single PDF). Eighth chapter of Part II ("Anorectal Disease").

Type: Specialty textbook chapter (reference/background, not primary literature).

Scope

Eighteenth chapter of the sequential full-textbook ingest (see ASCRS Ch01 - Anatomy and Embryology for the ingest's scope/plan). Covers anorectal STIs broadly: anorectal immunology (mucosal barrier, HPV/HIV coinfection interaction), screening/prevention (CDC recommendations, PrEP/ PEP, vaccination, mandatory reporting), diagnosis/initial evaluation (asymptomatic vs. symptomatic presentation, workup, empiric treatment algorithm), bacterial STIs (chlamydia, lymphogranuloma venereum, gonorrhea, syphilis, chancroid, donovanosis), viral STIs (herpes simplex virus, genital warts/condyloma acuminata, giant condyloma/Buschke-Löwenstein tumor, molluscum contagiosum, HIV incl. HIV-specific anorectal disease patterns), and ectoparasitic STIs (pediculosis pubis, scabies incl. crusted/Norwegian scabies).

Key content

Filed as a single comprehensive new page, Anorectal Sexually Transmitted Infections — unlike Ch12/13/16, this chapter's many sub-entities share one unifying clinical framework (presentation, screening/diagnostic algorithm, treatment philosophy) rather than being arbitrarily grouped unrelated conditions, so no split into per-organism pages was used. Cross-links added to Pruritus Ani (supersedes/expands that page's brief "STIs more broadly" subsection), Anal Fissure (fuller HIV-anal-ulcer content), Hemorrhoids (HIV/immunocompromise hemorrhoidectomy-safety framework), Anorectal Abscess and Anal Fistula (HIV-anorectal-disease context), Anal Stenosis (condyloma-excision and STI stenosis causes), and Colorectal Anatomy & Embryology (HPV 16/18 oncogenic subtypes at the anal transition zone, setting up background for the queued ASCRS Ch19/Ch20 anal-neoplasia chapters).

Limitations

  • Textbook chapter, not primary literature; cited trial/cohort data (McCormack and Molina PrEP trials, Diaz-Mitoma famciclovir RCT, giant condyloma sleeve-resection series) are the chapter authors' synthesis, not independently re-verified.
  • Explicitly notes true anorectal-specific STI incidence is hard to quantify (most population surveillance is genital-site-focused), and that ~85% of rectal STIs in MSM are asymptomatic.
  • Anal dysplasia/AIN content is kept intentionally brief in this chapter and in the resulting wiki page — full disease-specific content is deferred to ASCRS Ch19 ("Anal Intraepithelial Neoplasia") and Ch20 ("Anal Cancer").
  • Donovanosis and chancroid diagnosis are both explicitly noted as difficult given culture limitations — true US incidence for both is likely underestimated.

Relevance

Eighteenth entry in the ASCRS ingest. Adds one new, unusually broad condition page consolidating anorectal STI content, with the widest cross-link fan-out of any single-topic new chapter so far (seven already-ingested pages touched) given how many existing anorectal-condition pages had already named HIV, HPV/condyloma, or other STIs in passing. Chapter 19 continues Part II with "Anal Intraepithelial Neoplasia."