MSM risk behaviors linked to diarrheaIncreased Prevalence of Symptomatic Human Intestinal Spirochetosis in MSM with High-Risk Sexual Behavior in a Cohort of 165 Individuals.
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We explored the connections between human intestinal spirochetosis (HIS) and its symptoms, particularly diarrhea, in a group of individuals diagnosed at a tertiary hospital in Madrid. Our focus was on understanding how risky behaviors, especially among men who have sex with men (MSM), impact the prevalence of HIS and associated gastrointestinal issues.
In our review of 165 patients diagnosed with HIS, we found that most were male, with a significant majority identifying as MSM. Notably, a substantial portion of these individuals reported engaging in chemsex and unprotected oral-anal intercourse. Overall, 81.1% of patients were symptomatic, and diarrhea, notably the most common complaint (68.3%), raised concerns about the link between HIS and severe gastrointestinal distress.
Our analysis revealed that younger patients, particularly those under 41, had a higher likelihood of experiencing symptoms. Despite this, a high percentage (92.7%) had normal colonoscopy results. Interestingly, many patients also had previous or concurrent sexually transmitted diseases, which can complicate the diagnosis and treatment.
We observed that for symptomatic patients who did not have other gastrointestinal infections, treatment with metronidazole or doxycycline led to improvements. This highlights the importance of considering HIS as a potential cause of chronic diarrhea in MSM, especially after ruling out other conditions. Hence, we recommend this treatment approach for those exhibiting symptoms linked to HIS.
Diarrhea resolved
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