JMIR Publications

ABSTRACT

Sexually transmissible enteric infections are increasingly recognised among gay, bisexual and other men who have sex with men, challenging the traditional separation between sexually transmitted and enteric pathogens. Building on recent work demonstrating the feasibility of longitudinal sampling for these infections, we highlight the need to translate emerging epidemiological knowledge into gastrointestinal diagnostic practice. Patients with sexually transmissible enteric infections may present with proctocolitis mimicking inflammatory bowel disease, risking diagnostic delay, inappropriate immunosuppression and missed opportunities for transmission control. We propose a risk-adapted diagnostic approach incorporating sexual history taking, initial rectal STI testing, selective multiplex gastrointestinal molecular testing and judicious use of colonoscopy. Such pathways may support precision medicine, antimicrobial stewardship and public health surveillance.