sexually transmitted infection

As stewards of anorectal primary care, colorectal surgeons must be well-versed in treating patients with anorectal sexually transmitted infections (STIs).  Join Avery, Biddy, Jon and Sam as they share stories, cases and insights on how they manage STI-related anorectal pathology. 

CO-HOSTS

Avery Walker, MD, FACS, FASCRS
El Paso, TX

Avery Walker is dually board-certified in General Surgery and Colorectal Surgery. He earned his medical degree at the University of Illinois in Chicago, his General Surgery residency at Madigan Army Medical Center in Tacoma, Washington, and his Fellowship in Colon and Rectal Surgery at The Ochsner Clinic in New Orleans. A former active-duty officer in the United States Army, Dr. Walker served 13 years as a general and colorectal surgeon with his most recent duty station in El Paso, TX at William Beaumont Army Medical Center. While there he was the Chief of Colon and Rectal surgery as well as the Assistant Program Director for the general surgery residency program. He currently practices colon and rectal surgery at The Hospitals of Providence in El Paso, TX. Dr. Avery Walker is married and has two daughters aged 13 and 9.

Biddy Das, MD, FACS
Houston, TX (Twitter @BiddyDas)

Dr. Bidhan “Biddy” Das has board certifications for both colon and rectal surgery, and general surgery. His passion for medical education and medical process improvement has resulted in book chapters and publications, and national and regional presentations on those subjects. Highlighting his medical expertise on fecal incontinence, he has been featured on patient education videos and national and international television and radio as a featured expert on these colorectal conditions. Dr Das also has a particular interest in surgeons redefining their careers -- he serves as both a software consultant and private equity consultant in Boston, New York City, and Houston.

Jonathan Abelson, MD, MS
Arlington, MA (Twitter @jabelsonmd)

Dr. Abelson was born and raised in Scarsdale, New York in the suburbs of New York City.  He has 2 older brothers and both of his parents are dentists.  Dr. Abelson went to college at University Pennsylvania, took 2 years off between college and medical school to work in healthcare consulting.  He then went to medical school at University of Virginia, returned to New York for general surgery residency at Weill Cornell on the upper east side of Manhattan.  Dr. Abelson then did colorectal fellowship at Washington University in St. Louis and am now at Lahey clinic in Burlington, Massachusetts for my first job after training.  He is 2 years into practice and has a wife and two sons. His wife works in wellness consulting and they have a dog named Foster who we adopted in St. Louis.

Sam Eisenstein, MD
La Jolla, CA  (Twitter @DrE_UCSD)

Sam Eisenstein is an Assistant Professor of Colon and rectal surgery and director of Inflammatory Bowel Disease surgery at UC San Diego Health.  He has worked there for the past 8 years after graduating both residency and fellowship at The Mount Sinai Medical Center in New York.  Sam is best known as the founder and organizer of the IBD-NSQIP collaborative, a large multi institutional data collaborative examining outcomes after IBD surgery, but he also is involved in several clinical trials for perianal Crohn’s and has extensive experience with stem cell injections for anal fistulae. He is also on the scientific advisory board for the Crohn’s and Colitis Foundation for his work on the next big IBD data collaborative, IBD-SIRQC (Surgical Innovation, Research and Quality Collaborative).  Sam has a Wife and 3 kids (6,8, and 3) and spends most of his free time running around after them these days, but also enjoys traveling and getting out into nature with his family.

April is STI Awareness Month. STIs are commonly discussed in sex ed curricula, but typically as a fear-mongering technique to discourage premarital sexuality.

We are excited to have Jenelle Pierce, Executive Director of The STI Project, break down the stigma and provide strategies for discussing STIs with partners.

The episode begins with this prompt: “A person is beginning to date and is exploring multiple potential dating, sexual, and or romantic relationships. What are some ways to help set initial conversations around STI or pregnancy prevention?”

• The Value of Honest Communication (2:00): “It’s important to be honest, if you are in any stage of a relationship, even a ‘talking stage’”, Jenelle says. “First of all, communicating the dynamic of that relationship to all your partners, making sure that those who are involved know and are in the same place and are comfortable with that.”

• Beginning the Conversation (4:00): Julia reflects, “I have many clients who have recently moved out of religious structures that have such specific rules around dating and sexuality and never learned the skills to have a dialogue about sexuality in general and different components about sexuality, including STIs. And those conversations can feel very anxiety provoking for folks.” Many folks who grow up in religious structures typically do not even have a starting point for conversations about sex and sexuality, so it can cause fear and anxiety to even begin that dialogue because of the idea that talking about sex is shameful.

• Misconceptions About Open Relationships (13:00): Jenelle shares, “The assumption is that they're (people in polyamorous relationships) potentially higher risk and that there are more STIs within those communities. […] But it's actually the other way around. So research tells us that those who have known infections are less likely to transmit their infection than someone who has an unknown infection.” This shows how vital comprehensive sexual education is. People who are more inclined to have honest and open conversations practice safe(r) sex.

• The Psychology of Disgust (22:00): Jenelle explains, “Disgust is one of the core central emotions that helps us to navigate life in a way that we can be healthy and productive. And so it's a central emotion that's necessary from an evolutionary standpoint. Your risk assessment and disgust sensitivity changes and is dynamic intentionally also to benefit you because we need those relationships. The actual exchange of bacteria that happens when we're in close proximity to one another is good for our immune system and our overall health.”

Learn more about Jenelle and The STI Project on Instagram.

Let’s heal together!

In this episode, Dr. O discusses everything you need to know about this topic.