Anal dysplasia and proctitis (inflammation of the rectum); what do you think?

Question

I am an HIV positive male. I have had Proctitis for the last 4 1/2 months. This includes inflammation of the rectum, rectal pain; feeling i have to "go".... rectal discharge and pain/discomfort. Ruled out: gonorrhea, chlamydia, CMV, no warts (I had a sigmoidoscope) internal or external, pathology lab was negative. The colorectal surgeon did say he saw small external hemorrhoids . I guess I have non-specific proctitis... go figure. I JUST started HAART 2 days agos-- i was finally ready. Maybe this will clear up the proctitis? No other problems. My HIV Doc suggested that I might consider a test for anal dysplasia. Is proctitis a symptom for this? If they do an anal scraping... isn't it true that it's just "precancerous" and they aren't sure if it will ever develop into cancer... ?? I'm confused. Thank you!

Answer

I'm not sure I have the final answer to what sounds like a very unpleasant situation. You mention no gonorrhea, chlamydia, CMV, and warts. Has your doctor checked you for Herpes? Herpes can and often does cause the symptoms which you describe. It is very reasonable for you to have a PAP test. I recommend in all HIV positive patients, but particularly gay men. How much the more so for you, given your proctitis (inflammation of the rectum). If you don't get better, I would suggest that you see a gastroenterologist, a specialist in bowel disorders. Hope you get an answer. Good luck.