Herpes infection of the anus can be controlled and minimized, its not all bad news and the family life doesn’t have to suffer.
60% of the millions of people infected with herpes don’t know that they’re carrying the virus. Of the remaining 40%, most don’t really understand the virus or how it works.
Herpes infections can affect a number of different areas, including the anus where it’s often mistaken for hemorrhoids, anal fissures, or another anorectal disorder. Fortunately, once you know what to look for it’s fairly easy to tell the difference between a flareup of herpes and the other unfortunate disorders that can affect the area.
Cause of Herpes
Anal herpes is caused by the herpes simplex virus variations 1 and 2.
The herpes family includes these two plus the two strains of herpes zoster, responsible for chicken pox and shingles respectively. While the differences between the simplex strains and the zoster strains is pretty significant, the difference between simplex strains 1 and 2 is not nearly so large. Both can cause cold sores on the face and genital/anal herpes.
The biggest difference is where each particular strain prefers to reside. Herpes simplex type 1 prefers residing in the spinal nerve cluster near the ear, while type 2 prefers the sacral nerve bundle near the tailbone. However, both can infect the other’s preferred site fairly easily with only minor changes in behavior.
Herpes simplex is spread through a number of means, including simple touch. Unlike some other STDs, herpes is not dependent on large transmissions of bodily fluids to jump from one person to another.
It can spread through fingertip touch, which means that even children who suffer from cold sores can give themselves genital herpes by touching a cold sore on their lip and failing to wash their hands before wiping in the bathroom. They also frequently give cold sore-generating herpes simplex to each other by the same means.
Keep in mind that herpes has a shedding stage, where the virus starts to multiply in the nerve ganglia and getting into bodily fluids like saliva and genital fluids, but no symptoms have presented yet. During this symptom-free shedding stage, the virus can still be spread from one person to another, which is why it’s important to always be careful about your own body fluids.
Symptoms of Anal Herpes
The symptoms of anal herpes are reasonably unique, but only if you know all of what you’re looking for. If you’re not paying attention, anal herpes can be mistaken for hemorrhoids, anal fissures, an allergic reaction, heat rash, a yeast infection, ingrown hair follicles, abrasions, jock itch or even insect bites. The reason these false diagnoses come up is because people are only paying attention to one or two symptoms instead of all of them.
The process of elimination by consideration of symptoms is called “differential diagnosis”, and it’s essential to dealing with the anorectal region.
So, in the interests of accurate diagnosis, all possible symptoms of anal herpes should be investigated.
Anal herpes, along with hemorrhoids and anal fissures, can cause a knife-like pain during bowel movements with the pain lasting for up to 15 minutes after the movement’s complete. This pain is often described as “like passing glass.”
Anal herpes can also leave bright red blood on the toilet paper, in the bowl or on the stool. It can even make you feel as though you have to pass a movement constantly.
When herpes manifests around the anus, it often forms a small crack or fissure instead of the more typical blisters, ulcers or rash. In a sense, it really is an anal fissure, just one with a viral cause instead of from overstraining.
You also may notice a bloody or mucus discharge.
The real symptoms that differentiate anal herpes from everything else are the specifics that identify an infection, such as swollen lymph nodes, fever, headache, muscle ache, burning sensation in infected area, lower back pain, and recurrence of symptoms. The infected area is usually painful and will probably itch, burn or tingle right before and during an active outbreak.
If you have these symptoms in concert, you may have anal herpes and need to make a doctor’s appointment.
Both forms of herpes simplex have a first outbreak, a direct result of getting the initial infection, and recurrent outbreaks. Some people don’t suffer from recurrences, but most do.
First Herpes Outbreak Symptoms:
After the initial contact with the herpes simplex virus, the initial outbreak usually happens between 2 and 20 days. It can continue for up to 21 days, and you can expect it to stick around for 10 days at a minimum.
This first episode is usually the most severe, because the initial outbreak represents the first time the body’s had to deal with this particular virus. That means you have no active antibodies yet, your body hasn’t had time to produce them.
People who have herpes simplex in other parts of the body, such as cold sores, may have a less severe initial outbreak in the new place because they already have partial immunity.
The first attack doesn’t always produce visible sores, and it may even go unnoticed if other medical conditions are present.
However, the symptoms of infection will usually present themselves if you’re going to have a problem with the virus.
Keep in mind that a small percentage of infected people have never had a single symptom, but are still contagious. This is why frequent STD testing is a good idea if your current lifestyle indicates it. Whether you have an active sex life, work frequently with small children, or work around potentially biohazardous waste, all three are high contagion vectors and indicate the need for testing.
Herpes Cycle of Outbreak:
Herpes simplex outbreaks tend to follow a similar pattern no matter where they are.
This cycle is the same for initial outbreaks and recurrences. The biggest difference is that recurrences tend to be shorter and less severe. Keep in mind that this cycle is only the usual course, and that any given stage could be skipped due to your own immune response.
The first stage is the inflammation of the primary infection site. That means wherever the virus entered the body. This inflammation can cause swelling, redness, tenderness, itching and sensitivity. Initial inflammation might or might not progress to blisters.
The second stage is usually blisters, which is to say that you might notice one or several small, fluid filled sores or a fluid-filled rash. These blisters may look like small fissures filled with fluid, especially in the case of anal herpes.
The next stage is, of course, ulceration. This is what happens when the blister pops and the fluid leaks out. The blisters promptly turn into small, wet looking ulcers leaking milky or clear fluid.
If the ulcers are left alone, they will dry out, develop a scab and crust over. This represents the beginning of the healing process, but is one of the more dangerous periods for developing secondary infections, especially in the bacteria-rich anal environment – Open ulcer, plus active bacteria, with a dash of insufficient hygiene thrown in, is a bacterial infection begging to happen.
Be gentle with herpes ulcers, give them a chance to scab over and heal without getting infected. Eventually, the herpes sores or fissures will heal. The scab will fall off and new skin can be seen. This new skin is usually silver or red in color. Keep in mind that you might miss the scabbing stage, but you’ll probably still see this one. Once the scab has fallen off and the new skin is in place, the skin is safe to touch. At this point, the virus has retreated away from the surface and back into the nerve cluster. However, up until this point is complete, you’re still contagious.
The healing stage normally does not leave scarring unless other trauma (like wiping too hard) has occurred to the area.
Recurrences of Herpes:
Recurrences are an unfortunate fact of life for people infected with any kind of herpes simplex virus. These recurrent episodes happen when the virus starts replicating in the spinal nerve cluster near the site of primary infection. The replicated virus travels down the nerves to the surface of the skin, and a recurrent outbreak isn’t far off.
Keep in mind that the virus wakes up and becomes contagious a few days before symptoms start, so remember to protect yourself and others at ALL times.
Most people suffer about four recurrences per year, which diminish over time in both severity and frequency. These recurrences are usually preceded by prodromal symptoms – that is symptoms that idicate that an outbreak is about to happen, as opposed to symptoms of an outbreak – which are signs that the virus is getting ready to go active.
Recurrences occur in the same place as the initial outbreak, but can also occur simultaneously anywhere in the region served by the nerve ganglia in question. If you have the anal area as the site of the herpes primary infection, you may get mild, one to two day outbreaks on the genitalia, thighs, buttocks, or anywhere in that region.
In addition, after the lesions have healed and skin healing has occurred, you may still have pain and discomfort in the site of primary infection for a few days longer.
80% of people who suffer from herpes simplex 2, the genital herpes virus, in the sacral ganglia will experience at least one recurrence. If the sacral ganglia is infected with herpes simplex 1, the cold sore version, then they stand a 50% chance of having a recurrence.
On the bright side, the vast majority of viral activity occurs within the first year after infection.
Physical triggers for Herpes Recurrence:
The herpes virus goes and stays dormant based on the strength of your immune system. Because herpes outbreaks are dependent on your immune system, anything that depresses that immune system may contribute to a recurrent breakout.
The most common physical causes for herpes breakouts are exhaustion, malnutrition, other active infections, menstruation, high levels of alcohol consumption, exposure of area to UV light (sunlight), immunocompromise from diseases like HIV or medications for cancer, prolonged periods of physical stress, friction or damage to the skin of the primary infection site and surgical trauma of any kind.
Psychological triggers for Herpes Recurrence:
Of course, the immune system swings up and down based on psychological health as well.
Periods of prolonged psychological stress can cause frequent recurrences. This often perpetuates a vicious cycle because, ironically enough, many people seem to experience anxiety and stress from having herpes. During a recurrence, it’s important to not stress as much as possible.
Yes, herpes is a miserable thing to live with, but stress won’t change it while calm, healthy living will.
Herpes Prodrome Symptoms:
Getting to know the symptoms of an oncoming herpes outbreak can be quite handy, especially if you’re taking medication to manage it.
You’re looking for itching, tingling, numbness, burning, general fatigue, flu-like symptoms, fever, swelling of local lymph nodes, headache, painful urination, pain in the buttocks, backs of legs, and the lower back. If you’re experiencing these symptoms, have never had them before and don’t know what’s going on, you need to see a doctor. You may be having your first outbreak, or you may be suffering from a different sort of infection entirely.
However, if you already know you have herpes and you start feeling these symptoms in relation to your primary infection site, an outbreak is most likely on its way.
Unfortunately, there is no cure for herpes. Once you have it, you will have it for life.
The recurrences of active infection become less likely and less severe over time, but the virus remains dormant in the spinal nerves forever. Therefore, you always need to tell family and sexual partners that you suffer from herpes so that your nearest and dearest don’t pick it up from you by accident.
Always use condoms, you can be shedding the virus in bodily fluids before you start having active symptoms and no other form of protection will work.
Non-steroidal anti-inflammatories are usually used to treat symptoms throughout outbreak.
Antibiotics don’t work against a virus.
While anti-virals exist to help manage herpes, they’re rare, expensive, and do not offer a cure.
Many herpes patients find NSAIDs effective for prodrome discomfort and during active episodes.
Herpes must be treated by a qualified doctor because lesions can be overlooked, sores can be invisible to the naked eye, and a doctor needs to keep an eye on the strength of your immune system to ensure that the virus won’t damage you beyond repair.
Acyclovir, valacyclovir and famicyclovir are the three medications most often prescribed for herpes, and these three can do a lot to cut down recurrence frequency and length. All three require a doctor’s prescription and ongoing checkups.
If you’re female and pregnant, you need to tell your doctor you have herpes so you don’t pass it on to your newborn by accident. While herpes is not usually fatal to adults, it can be to small children.
At home you can keep yourself healthy, limit your stress, place lukewarm or cool cloths on sore place or places, take lukewarm baths, keep area dry and clean, wear loose fitting clothing and cotton underwear.
Home Remedy that takes 72 hours – 3 days – to cure an outbreak
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Research and main write by Loni L. Ice, editing and additional writing by D. S. Urquhart.
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