Shigella: the sneaky sexually transmitted infection you might not know about

Bad case of diarrhoea? Maybe it's shigella

Shigella might sound like a drag act paying tribute to Nigella Lawson but it’s an increasingly common sexually transmitted infection and it’s not to be taken lightly.

Currently on the rise among gay and bisexual men, shigella is a type of bacteria that can lead to a nasty gut infection. It is contracted through the ingestion of faecal matter (poo), often through sex acts such as rimming or anal-to-oral sex without using a condom.

Symptoms include nausea, vomiting, severe diarrhoea, pain in the abdomen and fever. Food poisoning has similar symptoms so it’s easy to brush them off and simply blame the suspicious-looking chicken you had for dinner last night. But, while shigella is treatable, symptoms are not to be taken lightly – and, if left untreated, can lead to hospitalisation.

If you start to experience symptoms, the first step is to rest as much as possible and stay hydrated. If symptoms persist for more than 48 hours, or if they worsen, then it’s important to seek medical advice. Schedule an appointment with your doctor or a sexual health clinic.

To avoid the risk of a misdiagnosis, you should inform them that you’ve had sex and you think you have shigella. Flagging it in this way means your doctor will know which tests to run and which antibiotics to prescribe. They may not have come across shigella in their patients before so this will ensure that they can offer you the most appropriate treatment and support.

Minimising the risk of catching shigella starts with basic hygiene. Wash your hands regularly, especially after handling used condoms or toys. It’s also recommended to change condoms in between anal and oral sex to decrease the chances of faeces being passed to the mouth.

Thirty-year-old Jake from London contracted shigella during the summer of 2021, and has shared their experience with the unpleasant illness.

‘I initially woke up in the middle of the night with flu symptoms. Really hot, clammy and sweaty. Took paracetamol, went back to sleep and felt fine the next day. I even went to the gym. But then at midday it started and felt very similar to food poisoning. I was only ever sick once, but it was the worst diarrhoea of my life.

‘I couldn’t keep food down and had zero appetite. The doctor said it was probably a bug, to stay hydrated and weather the storm. But then blood appeared in my diarrhoea so I rang the out-of-hours number.’

Despite the concerning symptoms, Jake’s worries were mostly ignored and, when the blood tests initially came back clear, Jake was sent home. However, they were still experiencing symptoms similar to irritable bowel syndrome a month later.

‘I rang my GP and asked for some tests. They told me everything was clear. Five minutes later she phoned me back and said, “Sorry, I missed it in the results but you have shigella.”

‘The doctor couldn’t really explain what it was. I’d done research by now so I said presumably I got it as a gay man from rimming. She said no action was required – that I’d had it and [it was] still appearing in the tests, but it’ll pass.’

Jake’s story is an example of why it’s important to seek medical advice as soon as you start to experience symptoms, and why it’s vital to be open with your doctor so they can assess you accurately and get you on the correct treatment right away.