WARNING — A common intestinal bacteria causing severe diarrhea has become increasingly hard to treat; and it is being spread more frequently through sexual contact especially among gay and bisexual men as stated by public health agencies in both the United States and Europe.
Shigellosis typically transmits through contaminated food, water and/or contaminated hands. But a CDC review of nearly 17,000 US samples found that strains resistant to all five standard antibiotics rose from 0% of samples in 2011 to 8.5% in 2023. In England, more than half of S. sonnei cases in 2025 were extensively drug-resistant.
Physicians are recommending testing for patients who have persistent or bloody diarrhea after having sex. Doctors are stating that if a patient discloses possible sexual exposure, he/she will be given the correct antibiotic treatment.
The centers for disease control (CDC) says to go see a doctor if you believe you’ve contracted shigellosis (Shigella), the sexually transmitted disease associated with “sexually transmitted diarrhea”.
Warning signs: You should see a doctor immediately if you experience:
Fever
Diarrhea with blood; or diarrhea lasting more than three days
Sudden onset of severe abdominal pain; or persistent or worsening abdominal tenderness.
Signs of dehydration such as dizziness, black/dark brown urine or very little urine.
See a doctor right away if you have a compromised immune system due to an illness or treatment such as HIV/AIDS, or chemotherapy. Your risk of becoming severely ill is much higher.
When seeing a doctor about your potential sexually transmitted infection (STI)
Inform your doctor that you suspect you got infected through sexual contact. Because many strains of this bacteria can develop antibiotic resistant properties, informing your doctor that you got infected through sexual contact could cause them to prescribe an alternative medication.
Request a stool test. This laboratory test will confirm the type of antibiotic that would effectively treat the specific strain(s) of the bacteria present.
Do not use left over antibiotics. Using the wrong antibiotic on the same bacteria can lead to increased development of antibiotic resistance and result in decreased effectiveness of future treatments.
Monitor yourself and return to the doctor
Return to the doctor if you do not notice improvement within two to three days of beginning antibiotics. Return to the doctor so that they can perform additional testing to determine whether you have developed a new strain that requires a different antibiotic. Follow all instructions given by your doctor.
Care for yourself
Rest and drink plenty of liquids. Many patients with mild infections will require nothing else. Most patients recover completely within five to seven days without needing antibiotics.
Use Pepto-Bismol (bismuth subsalicylate) to alleviate diarrhea.
Do not use anti-diarrhea medications such as Imodium or Lomotil when you have bloody diarrhea. These medications slow down digestion and may exacerbate your condition.
It may take some time to recover completely
Your symptoms may persist longer than expected and it may take some time for your bowel movements to return to their normal state. It is possible that your recovery process may take anywhere from four to six weeks, or even months.
