Hemorrhoids (swollen veins in and around the anal opening) cause most rump-related complaints. By age 50, roughly half the population (HIVer or not) suffers ’rhoid rage. The misery can begin when constipation pressures the walls of the rectum, constricting veins and making them swell (see “Potty Mouth,” for tips on nipping constipation). Hemorrhoids can be external (visible at the anus—they look and feel like small red grapes) or internal (discovered only by an oh-so-pleasant finger exam). They can itch, hurt and bleed if irritated. For temporary relief, topicals (like Preparation H) and sitz baths (with Epsom salts and warm water) can reduce swelling. A short surgical procedure removes severe ’rhoids. Get more info at www.niddk.nih.gov/health/digest/pubs/ hems/hemords.htm.
Anal warts are caused by human papilloma virus (HPV), and they’re not just a bummer—they’re contagious. Worse, some HPV strains can morph cells into precancerous or cancerous lesions. HPV—and its warts—can turn up in HIVers homo or hetero, male or female, with no anal-sex history—and persistent cases are about seven times more common in HIVers. So ask your doctor for an annual anal Pap smear even if you have no symptoms (and whether or not you swing with rear-door sex). Don’t be embarrassed—you can’t always save face and ass at the same time. If you’ve got ’em, find a gastrointestinal doctor or colorectal surgeon who treats HIVers with warts and worse. These docs are likely to be up to speed on the latest standards for screening and treatment.