I thought I had hemorrhoids. My ID Dr. says I have perirectal ulcers and a fistula. The referral to GI generated an appointment for a flex sigmoidoscopy and possible biopsy next week. Herpes and syphilis have been ruled out. Is there a connection between AIDS and inflammatory bowel disease--maybe even Crohn's disease? I also have porphyria cutanea tarda. Is there a connection there as well? I was diagnosed 12/98 with CD4 of 12 and viral load of 187,000. Now am Cd4-340, viral load-ND. I am 54 years old, male. AIDS/drug side effects--diarrhea and fatigue.

Perianal ulcers and fistulae can occur in HIV-s as well, and are not necessarily part of inflammatory bowel disease (which itself is not associated with HIV). These problems can happen to people who practice anal intercourse, and can sometimes be caused by a specific organism, such as Herpes simplex virus. In other cases, no specific cause is found and the problem is treated with sitz baths (warm soapy water soaks), antibiotics, and occasionally surgery if the fistulae or fissures don't heal by themselves.