Yes—some infections that cause diarrhea can spread during sexual activity involving contact with feces. Shigella is a clear example, and antibiotic resistance is a documented concern. But the evidence cited here does not establish that sexually acquired diarrhea is “exploding” nationwide in the United States. The available annual case estimate covers all Shigella infections, not just those acquired through sex.
What “sexually transmitted diarrhea” means
It is a colloquial description, not the name of one infection or a separate sexually transmitted infection category. It refers to enteric infections—illnesses affecting the intestines—that can spread during sexual activity when germs from stool reach someone’s mouth. Shigella is a well-documented example. The CDC also discusses Campylobacter in its guidance on sexually transmitted enteric infections.
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Shigella germs are present in stool. Infection can occur when someone swallows even a small amount of material contaminated with infected stool. That contamination may be on hands, sex toys, or skin around the anus and genitals, including the thighs and buttocks; it may not be visible. The CDC describes possible transmission during oral-anal, oral-genital, anal-genital, and digital-anal contact. For details, see the CDC’s prevention guidance for sexually active people.
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Clear out junk files and repair common Windows errorsFree Scan →Scan for outdated or missing drivers - takes under a minuteDriver Scan →Is sexually acquired diarrhea increasing across the United States?
The sources cited here do not establish a current national trend showing that sexually acquired diarrhea overall is rapidly increasing. The CDC estimates about 450,000 Shigella infections in the United States each year, and estimates that 242,000 of those infections are antimicrobial-resistant. Both figures, published in the CDC’s clinical overview of shigellosis in 2024, cover Shigella infections from all transmission routes—not a count of sexually acquired cases.
Those totals show that Shigella and resistance matter as public-health concerns, but they cannot establish how many cases came from sexual contact or whether that number is rising. Keep that distinction in mind when interpreting headlines about sexually transmitted diarrhea.
What the resistance figures do—and do not—show
Antibiotic resistance in Shigella is a real clinical concern. The CDC says resistance to trimethoprim-sulfamethoxazole, ciprofloxacin, and azithromycin is widespread. Its 2024 overview also reports that the share of isolates resistant to both azithromycin and ciprofloxacin has increased since 2017 in National Antimicrobial Resistance Monitoring System (NARMS) monitoring.
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A narrower measure is extensively drug-resistant (XDR) Shigella. A 2023 CDC health alert reported that XDR strains accounted for 0% of reported U.S. Shigella infections in 2015 and 5% in 2022. The estimate was preliminary and based on sequenced isolates submitted to PulseNet, with susceptibility testing and/or resistance markers from whole-genome sequences. It is a percentage of reported Shigella infections—not a percentage of sexually acquired diarrhea cases. Read the CDC alert on XDR shigellosis for its methods and qualifications.
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When to seek care and how diagnosis works
Diarrhea can have many causes, and symptoms alone cannot confirm Shigella. If you have diarrhea after a possible exposure, or symptoms that are bloody or prolonged, contact a health professional. Tell them about the symptoms and any relevant sexual exposure so they can consider an enteric infection and appropriate testing.
Stool testing can identify Shigella. CDC guidance for clinicians recommends laboratory evaluation, including stool culture, for relevant patients with diarrhea. A health professional can decide which tests and treatment are appropriate based on the illness and test results.
Why you should not choose antibiotics yourself
Many people with Shigella recover without antibiotics, but a clinician may recommend treatment in some cases. Because resistance is common, the right choice depends on susceptibility results for the individual isolate or, during a local outbreak, resistance information for the outbreak strain. The CDC advises selecting an antimicrobial on that basis when treatment is indicated. Leftover antibiotics or a drug chosen without clinical guidance may be ineffective and can complicate care.
Independent reader supportYour contribution helps us test, update, and keep practical guides available for everyone.How to reduce the chance of spreading Shigella during sex
The CDC recommends specific steps because Shigella can remain in stool after symptoms improve. The germ may continue to be present in stool for up to two weeks after diarrhea has gone away.
- Avoid sex while you have bloody or prolonged diarrhea.
- Wait at least two weeks after diarrhea ends before having sex.
- Wash hands, genitals, and anus with soap and water before and after sexual activity.
- Wash shared sex toys after each use.
These steps reduce opportunities for fecal contamination; they do not guarantee that infection cannot spread or prevent every sexually transmitted infection.
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What to take away from the headline
Diarrhea-causing infections such as Shigella can spread through sexual contact involving fecal exposure, and Shigella’s antibiotic resistance is a documented concern. However, the CDC statistics available here describe Shigella overall, and the XDR figure describes reported Shigella infections—not sexually acquired cases. They do not verify that sexually transmitted diarrhea is exploding nationally.
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