Gay bowel syndrome

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Gay bowel syndrome is a medical term first used by Henry L Kazal and colleagues in 1976 to describe the various sexually transmitted perianal and rectal diseases and sexual traumas seen in Kazal's proctology practice, which had many gay patients.

History[edit]

After Kazal, the term was used sporadically in medical literature from the 1970s to refer to a complex of gastrointestinal symptoms affecting gay men. The term was first used in the pre-HIV era, by Kazal et al. in 1976.[1][2] The term was not specific to any particular disease or infection, and was used clinically to describe proctitis and a variety of other complaints caused by a wide range of infectious organisms. Reported causes include hepatitis viruses, syphilis, gonorrhea, chlamydia, campylobacter, and shigellosis, as well as a variety of protozoal infections.[2] The concept of "gay bowel syndrome" was later expanded to include various opportunistic cancers. Transmission of disease was considered to take place by two routes: anal sex, and fecal-oral route (anal–oral sex or coprophagia). Sometimes, difficulty in specifying the method may be a result of transmission by both methods.[2] Following the onset of the AIDS epidemic, the reported incidence of these complaints has declined, likely as a result of changing sexual practices.[3]

Diarrhea[edit]

Those with the ano-rectal disorder experience increased incidents of diarrhea.[4]

Usage[edit]

The term "gay bowel syndrome" is considered obsolete and derogatory by some. The McGraw-Hill Manual of Colorectal Surgery says:

Coined in the pre-HIV era, the term "gay bowel syndrome" comprised a rather unselective potpourri of unusual anorectal and GI symptoms experienced by homosexual males... with better understanding of the underlying causes, this term is outdated: the derogatory terminology should be abandoned and more specific entities and terms recognized and used.[5]

A 1997 article in the Journal of Homosexuality concluded:

It is apparent that Gay Bowel Syndrome is an essentialized category of difference that is neither gay-specific, confined to the bowel, nor a syndrome. The use and diagnosis of Gay Bowel Syndrome must be abandoned.[6]

The term "gay bowel syndrome" was withdrawn as "outdated" by the Canadian Association of Gastroenterologists in 2004,[7] and the U.S. Centers for Disease Control described the term as informal and no longer in use in 2005.[8] The gay activist and author Michael Scarce criticized the concept of "gay bowel syndrome" in his book Smearing the Queer: Medical Bias in the Health Care of Gay Men (1999), saying that "gay bowel syndrome has been, and remains today, a powerful tool for the specific surveillance, regulation, definition, medicalization, identification, and fragmentation of gay men's bodies."[9] Scarce's work has been cited in the Journal of the American Medical Association with a positive review.[10]

Footnotes[edit]

  1. ^ Kazal HL, Sohn N, Carrasco JI, Robilotti JG, Delaney WE (1976). "The gay bowel syndrome: clinico-pathologic correlation in 260 cases". Ann. Clin. Lab. Sci. 6 (2): 184–92. PMID 946385. 
  2. ^ a b c Kenneth A. Borchardt and Michael A. Noble (1997). Sexually Transmitted Diseases: Epidemiology, Pathology, Diagnosis and Treatment. CRC Press. pp. 296–305. ISBN 0-8493-9476-7. 
  3. ^ Bartlett, John (March 15, 2004). "New Look at "Gay Bowel Syndrome", Etiology of Clinical Proctitis Among Men Who Have Sex With Men.". Medscape. 
  4. ^ "Textbook of medicine", Robert L. Souhami, John Moxham. Elsevier Health Sciences, 2002. ISBN 0-443-06464-4, ISBN 978-0-443-06464-7. p. 817
  5. ^ Kaiser, Andreas (2008). McGraw-Hill Manual of Colorectal Surgery. p. 205. ISBN 0-07-159070-6. 
  6. ^ Scarce M (1997). "Harbinger of plague: a bad case of gay bowel syndrome". J Homosex. 34 (2): 1–35. PMID 9328857. 
  7. ^ Garbo, Jon (December 21, 2004). ""Gay Bowel Syndrome" struck from textbook". Gmax.co.za. Retrieved June 24, 2009. 
  8. ^ Lee, Ryan (April 8, 2005). "Activist fights 'outdated' medical phrase: Effort to debunk 'gay bowel syndrome' may face new challenge". Washington Blade. Retrieved June 24, 2009. 
  9. ^ Scarce, Michael (1999). Smearing the Queer: Medical Bias in the Health Care of Gay Men. Routledge. p. 13. ISBN 1-56023-926-3. 
  10. ^ Journal of the American Medical Association (2000). pp. 284