Fecal-Oral Transmission of STIs - An Overview

Introduction

Bacteria, viruses, and parasites can all spread from infected person to normal person, causing a variety of diseases. Sexually transmitted infections (STIs) can be transmitted in a variety of ways. These infections also spread via the fecal-oral route, and it denotes the route by which the pathogen present in the oral and anal region passes from one person to another. Many people can get severe forms of sexually transmitted infections (STIs) through the fecal-oral mode of transmission. It can be transmitted through skin-to-skin contact, genital fluid, anal fluid, anal and oral sex by using the lips, mouth, or tongue, which can cause the same risks as other sexual activities. The infection can be hepatitis A (viral infection) or shigellosis (bacterial infection). It can cause fever, abdominal pain, and diarrhea. The use of condoms can lower the risk of the same. Practicing good personal hygiene and safe sex practices can prevent the spread of sexually transmitted infections. Washing hands thoroughly and avoiding contact with the fecal matter or anal region may prevent infections.

What Is Fecal-Oral Transmission?

The fecal-oral route, in general, refers to the route of transmission for many types of diseases caused by bacteria or viruses. The infection occurs when pathogens from an infected person's feces are ingested by another person. This can be caused due to the ingestion of contaminated food or water.

What Are STIs?

Sexually transmitted infections are infections that are transmitted through sexual contact. Some STIs are severe with life-threatening symptoms, and some are without symptoms. The use of condoms and other barrier methods can reduce the risk of disease transmission. STIs include syphilis, the human immunodeficiency virus (HIV), hepatitis B, the human papillomavirus (HPV), and chlamydia.

What Are the Causes of Fecal-Oral Transmission of STIs?

Sexually transmitted infections (STI) could also be transmitted through the fecal-oral route through sexual activities like oral sex. It is evident that some STIs, like genital herpes or gonorrhea, are more frequently spread through such practices when compared with other STIs; the common factors in transmission through the fecal-oral route involve the skin and bodily fluids. The causes include -

• Oral Sex - The condition can be caused when infected anal fluids or feces come into contact with the mouth of the partner, which allows the transmission of STI. Transmission usually occurs when the mouth is used to stimulate the genital areas such as the penis or vagina and anal region (anus).

• Anal Sex - Skin-to-skin contact with the area around the rectum and anal region or oral contact with the anus can result in STI transmission.

How Can a Person Get STIs From Oral-Anal Sex?

STIs can be transmitted through oral-anal contact from one person to another. For example, a person with an infected anus comes in contact with a healthy person through the mouth and throat to acquire the disease. It means the STIs can pass through the anal area to the mouth. A person can get an STI through oral-anal contact with bodily fluids such as semen or anal secretion. This occurs when a mouth comes in direct contact with the anus. Some people believe avoiding penetrative sex can prevent infections, but sexual contact, like oral-anal sex, can also transmit the disease. In addition, STIs can affect more than one place simultaneously, like the mouth and anus.

What Are the Different Types of STIs Transmitted Through the Fecal-Oral Route?

Various STIs that can be transmitted through the fecal-oral route are listed below:

• Chlamydia - It is caused by Chlamydia trachomatis. The disease can be transmitted through oral sex, but more commonly through vaginal and anal sex. The infection can affect the throat, genitals, rectum, and urinary tract. The most common symptom is a sore throat.

• Gonorrhea - Gonorrhea is caused by the bacteria Neisseria gonorrhoeae. It mainly affects people aged between fifteen to twenty-four years. The infection can transmit through oral, vaginal, and anal sex. In addition, it can affect the throat, rectum, and urinary tract.

• Syphilis - The bacteria Treponema pallidum causes the infection. Syphilis can affect the genitals, mouth, anus, and rectum. It can cause severe life-threatening complications with organ damage. The symptoms include skin rash, swollen lymph nodes, and fever. In addition, the disease can affect the brain, nerves, eyes, liver, bones, and joints.

• Herpes Simplex Virus 1 (HSV1) - An viral infection can affect the lips, mouth, throat, rectum, anus, and genitals. The symptoms include blisters and sores.

• Herpes Simplex Virus 2 (HSV2) - The infection can be transmitted through vaginal, anal, and oral sex. The symptoms include blisters on the tongue, lips, and mouth, pain, difficulty swallowing, and joint pain.

• Human Papillomavirus (HPV) - The infection can be transmitted through oral, vaginal, and anal sex. It can affect the mouth, throat, genital, cervix, anus, and rectum. Symptoms include warts in the throat, difficulty in speaking, voice changes, and shortness of breath.

• Human Immunodeficiency Virus (HIV) - The infection is transmitted through vaginal sex and less through oral sex. The disease shows flu-like symptoms.

• Viral Hepatitis - The infection transmits through direct contact with infected blood, using infected needles, and through childbirth.

How Can Fecal-Oral Transmission of STIs Be Diagnosed?

If the person is suffering from a sexually transmitted disease, it is a good idea to visit the hospital for regular sexually transmitted infection screening. The person can also visit the clinic, if one has the following symptoms:

• Pain, itching, and burning in the anal area.

• Warts, sores, and bumps in the mouth or genitals.

• Unusual discharge from the anus and genitals.

• Pain in the throat, pelvis, lower abdominal region, and mouth.

• Anal bleeding.

• Pain during sexual intercourse.

A person can visit the clinic if the partner has a sexually transmitted infection due to condom breakage. The doctor may recommend a blood test and urine test to find the viral and bacterial infections related to STIs. In addition, the doctor may check the symptoms associated with the conditions.

How Can Contracting STIs via Fecal-Oral Transmission Be Prevented?

Most people are not aware that sexually transmitted infections are also transmitted through oral and anal sexual activities. There are various preventive measures to lower the risk of fecal-oral transmission of STIs, some of them are listed below:

• Avoid sharing towels.

• Use of condoms during penetrative sex.

• Barrier methods such as dental dams minimize the risk of STI transmission during oral sex.

• Maintenance of personal hygiene and good oral health.

• Practice safe sex and have only one sexual partner (undergone STI screening).

• Get vaccinated for pathogens causing sexually transmitted diseases.

• Getting regularly tested for STIs and asking the partner to do the same.

• Avoiding sexual activities when visible lesions (in the oral and anal region) such as herpetic sores or genital warts are seen.

Conclusion

Sexually transmitted infections are transmitted through the fecal-oral route and skin-to-skin contact, but that does not mean that people stop enjoying things. Instead, people must adopt preventive safe sex measures to protect their health. Several ways can make sex safer, including the use of condoms and the maintenance of personal hygiene. STI screening is necessary if the person is sexually active. Also, long-term monogamous mutual relationships screened for STIs prevents transmission. Healthcare providers, including doctors and nurses, can organize a camp and advise people about the transmission of STIs, their symptoms, and preventive measures.