Anal Sex and GI Issues: Can You Enjoy Anal Sex With GI Problems?

A few years ago, I found the perfect butt plug. Called Cupid’s Itty Bitty Beginner’s Plug, it was small, a pretty pastel pink, made with soft silicone, and complete with an external ring to make sure it didn’t get lost inside me. (Yup, that can happen.) After covering the plug in water-based lube (very necessary, as the anus isn’t self-lubricating), my partner inserted it into my butt to warm me up for anal sex.

We fooled around for 30 minutes or so, but when my partner took out the butt plug, it…wasn’t perfectly baby pink anymore. A few, er, brown spots dappled the smooth silicone. This incident happened some years ago, before I was more comfortable in my body. I got so embarrassed I called the whole thing off despite genuinely enjoying anal sex.

I have irritable bowel syndrome, or IBS. I also happen to really like anal sex. As you can imagine, the two don’t always go together.

The cause of IBS isn’t entirely known, although potential factors include overly active or underactive intestinal muscles, inflammation in the GI tract, an off-kilter gut microbiome, and more.

Not knowing the exact cause doesn’t change IBS’s effect on my body. I often experience symptoms like diarrhea that comes on suddenly, stomach cramping, and nausea. I also need colonoscopies every five years as I have a family history of colon cancer and am prone to polyps, or small growths along the colon that carry a risk of becoming cancerous if not caught early. My IBS can really throw a wrench into my life, including the whole anal sex thing.

I’m not the only person to crave receptive anal sex just to have the mood ruined by a gastrointestinal condition. “I bottom significantly less then I would like. I love anal, but I’m afraid I’ll shit on a casual encounter, which would be awkward as all hell,” LGBTQ writer, speaker, and activist Zachary Zane, who also has IBS, tells SELF. “[It] makes it more difficult for me to relax… It’s tough to enjoy sex if you’re worried you’re gonna explode.”

Many GI conditions besides IBS can cause symptoms that might interfere with anal sex.

Up to 70 million people in the United States are affected by digestive diseases, according to the National Institutes of Health.

One is IBD, or inflammatory bowel disease. This umbrella term describes disorders involving chronic inflammation of the digestive tract, such as ulcerative colitis and Crohn’s disease, the Mayo Clinic explains. These conditions can cause debilitating symptoms like severe diarrhea, intense abdominal cramping, and fatigue that makes it difficult to get out of bed—never mind have sex.

Another possible issue is chronic constipation, which is when you have consistent trouble pooping for at least three months, according to the Mayo Clinic. This is a symptom I sometimes experience with IBS. I can confirm that when you are totally backed up, there’s no way you’re backing up into anything.

There’s a whole host of other GI troubles that might interrupt your experimentation with anal sex, like peptic ulcers (which can cause nausea, heartburn, and stomach pain), anal fissures (painful little cuts in the delicate tissue down there), and hemorrhoids (piles of swollen veins that can prompt anal bleeding, pain, irritation, and itching, among other symptoms). Not quite a recipe for great butt sex!

“[With GI issues], it is the unpredictability of both frequency and severity of symptoms that disrupts one’s life,” Elena Ivanina, D.O., M.P.H., a gastroenterologist and assistant professor at Lenox Hill Hospital of Northwell Health, tells SELF. “[You] may not be able to guess when the stomach pain will hit and have you doubled over, or the strong urge to poop makes you run to the nearest bathroom.” Which brings us to our next point…

Real talk: If you have a GI condition, do you need to worry about pooping during anal sex?

Let’s chat about pooping during anal, because that’s probably why you clicked this story. It is a fact that sometimes, as they say, shit happens. “Sex can be messy … and it’s definitely true with anal sex, IBS or not,” licensed psychologist and certified sexologist Denise Renye, Psy.D., tells SELF.

There are two main possibilities when it comes to GI conditions specifically: that you will actively poop during anal because of, say, diarrhea, or that you might have extra stool in your rectum (the part of your large intestine closest to your anus) due to something like constipation.

The thing is that some residual fecal matter can hang out in your rectum even if you don’t have a GI condition, so, yeah, anyone with a functioning butthole might see some poop during anal, Dr. Ivanina says. Having persistent, somewhat unpredictable poop problems simply makes you a little more vulnerable to this.

That doesn’t, however, mean poop absolutely will crash your anal party. If it does, wash your hands and the affected body parts and reassess how much you feel like getting back to anal after that. If you’re going to continue with penetration and you were using a condom, you should grab a fresh one. If you were using a barrier method such as a dental dam for analingus, you’ll need a new one of those instead.

Should you use an enema before anal sex to decrease the chances of pooping?

Enemas are injections of fluid into the rectum to flush out any stool that’s in there. In general, it’s OK to use enemas “carefully and appropriately, but not on a frequent basis,” Dr. Ivanina says.

The muscles in the rectum typically know what they’re doing when it comes to keeping poop in or pushing it out. You don’t want to use enemas so often that you mess with your body’s natural defecation process, especially if you have a GI condition that’s already screwing with the way you poop. If you’ve never discussed enemas with your doctor, it can be smart to check with them before adding an enema into your routine.

Next up: Are you more likely to experience pain during anal sex if you have a GI issue?

“If someone has a GI disease involving the anus/rectum—for example, a flare of ulcerative colitis, a rectal ulcer, or an anal fissure—it may not be safe to have receptive anal sex,” Dr. Ivanina says. First of all, it might really hurt. But also, anything that increases your chances of exchanging fluids, like anal fissures that can leave bloody cracks in your skin, may put you or your partner at increased risk of sexually transmitted infections.

This is why you should always use condoms for penetration (including on toys) and barrier methods like dental dams for analingus. (The exception is if you and your partner are in a committed monogamous sexual relationship and have been tested recently.) If you are using a condom, you should always get a new one when switching between anal and vaginal penetration, otherwise you can deposit bacteria from your GI tract right into your vagina where it may cause an infection.

If you have a GI-related medical condition, are interested in anal sex, but are concerned about the poop factor, Dr. Ivanina suggests talking to your doctor about your treatment plan.

The goal is to get on as regular a pooping schedule as possible and decrease flares of any symptoms. That might include tweaking your diet by cutting down on triggers such as spicy foods and beverages like coffee and alcohol, exercising more to increase movement in your colon, and possibly getting on (or changing) medications for your specific situation.

This might be tough to do, but in an ideal world you’d also let your doctor know that you’re interested in trying anal sex. This can help them tailor their recommendations, plus it may be important for them to know for sexual health reasons.

With the right preparation, teamwork, and tons of lube, anal sex can be awesome—even for those with GI conditions.

Unless a medical professional has specifically told you that it’s unsafe or you’re having a flare of symptoms like pain, diarrhea, or constipation, it’s likely OK to try anal sex, Dr. Ivanina says. But protection is essential, especially since your condition might increase the risk that your partner will encounter substances like poop. And no matter how much lube you’ve slathered on, stop if you experience pain. Always listen to your body.

Also, it would be great to give your partner a heads up about your GI condition before trying anal sex. Having anal often involves some kind of conversation anyway, so it shouldn’t be that weird. Anyone who is worth having sex with shouldn’t freak out about this.

If a possible partner is an asshole about discussing how your condition may impact anal sex, they’re probably not worthy of entrance into your, well, asshole.

“At this point, I only bottom for guys I’m dating or more serious about, so if [there is poop], it’s not the end of the world,” Zane says. “We laugh, and then hop into the shower together. It comes with the territory, you know? If you’re playing around in the mud, you’re bound to get dirty sometimes.”

As someone who has pooped on dicks and farted during oral sex, I couldn’t agree more. “Many times, people are self-conscious, yet we are all humans, and any caring partner will understand any mess that may be present,” Renye says.

That partner I mentioned who saw poop on my butt plug? They’ve also escorted me home from two colonoscopies, witnessed me high on sedatives after said colonoscopies, and enjoyed crazy hot anal sex with me. Such is the only type of person who deserves the potential delight of venturing past your butthole.

Related: