I am 29, and I have been getting yeast infections in my rectum for about the past 10 years. I have never had a vaginal yeast infection. I can find no discussion about this condition, although information about vaginal yeast infections seems to be everywhere on the Net. Doctors have put me on creams and pills. Sometimes the infections respond to over-the-counter creams. I am not diabetic or immunocompromised; I wear cotton underwear and no tight clothing; I don't eat abnormal amounts of yeast-containing foods (that I know of), and I eat yogurt. Any tips on why I get these infections and how I can avoid them?

--Liz

The gastrointestinal tract is a reservoir for yeast organisms -- they like to live in the rectum, and all the topical therapy in the world will not eradicate this holding ground. Sometimes a long course (two weeks or more) of oral drug therapy is prescribed to decrease the amount of yeast residing in your gastrointestinal tract. The medications used are effective, but they may cause liver damage, so you must be closely monitored during the course of therapy.

It's important to determine whether your problem is really a yeast infection or something else. Perianal itching (itching of or around the anus) may also be caused by hemorrhoids, anal fissures or parasite infections such as pinworm. These possibilities should be eliminated by a physical exam and stool tests. A good way to diagnose pinworm is to place a piece of tape over the anus at night and take it in to the doctor for examination. Also, perianal irritation can arise from anal sex, which should be avoided if symptoms arise. A family doctor or gynecologist should be able to evaluate and treat you.