Why sexually transmitted disorders in the colon can be mistaken for ulcerative colitis: a survey study among Polish patients

Introduction
Ulcerative colitis (UC) is an autoimmune disease characterized by the formation of erosions and ulcerations of the colonic mucosa. Exclusion of infections, including sexually transmitted disorders (STDs), is particularly important in the differential diagnosis.

Aim
The aim of the study was to demonstrate the situation of Polish patients in the context of differential diagnosis of UC with STDs.

Material and methods
We used a questionnaire on sexual habits for patients with ulcerative colitis from two Polish centers for the treatment of inflammatory bowel diseases (IBD) and to Internet users with the diagnosis of UC affiliated with patient portals.

Results
The survey included 532 participants. 31.6% of all respondents reported practicing passive anal intercourse. 7.6% of patients admitted to unsafe sexual behavior, while among men who have sex with men (MSM) this percentage increased to 73%, with 55.4% of anal intercourse taking place without mechanical contraception. During medical visits related to the diagnosis or exacerbation of UC, the vast majority (87.2%) of patients were not asked about either anal sexual intercourse or sexual orientation, and 76.7% were certainly not tested for STDs.

Conclusions
The vast majority of Polish patients with UC are not asked about anal intercourse or tested for STDs. Simultaneously, considering the percentage of patients at risk for STDs, it is reasonable to assume that this is a genuine problem and may lead to diagnostic mistakes.