Asking for a Friend: Can You Have Anal if You Have IBS?
First off: Is it safe to have anal sex with IBS?
There isn't a one-size-fits-all-asses answer. Why? Because IBS itself does not present the same amongst all people who have it, explains Daniel O’Shaughnessy, an award-winning nutritionist and author of Naked Nutrition, an LGBTQ+ guide to diet and lifestyle.
“Generally speaking, it is safe to have anal sex if you have IBS and your symptoms are under control,” says Elena A. Ivanina, DO, MPH Director of Neurogastroenterology and Motility with Lenox Hill Hospital. However, if someone is currently experiencing symptoms—such as pain, uncontrolled diarrhea, bloating, or abdominal cramping—then they should see a gastroenterologist to come up with a care plan for their condition before anal play, she says.
Okay, but am I more likely to poop during anal if I have IBS?
“No, you’re not necessarily more likely to poop during anal sex if you have IBS,” says general surgeon Evan Goldstein, DO, a doctor in New York City who specializes in anal care and the founder of Bespoke Surgical and Future Method.
Poop is not stored in the anal canal, it merely passes through it, he explains. It's technically stored higher up in the body in a section of the large intestine called the rectum, which is separated from the anal canal with a muscle called the internal anal sphincter.
Typically, Dr. Goldstein says, this muscle only releases to let poop pass through the canal after your brain has sent your body that “I have to poop” signal (you know the one!). So, unless you ignore the “TOILET NOW” message from your brain, the odds of you pooping during anal sex is very rare—and that stands for people with or without IBS. “If you have IBS you don’t need to be afraid of pooping during anal play unless you are experiencing a bout of IBS-related symptoms,” he says.
In actuality, people with IBS may be less likely to make a mess during anal, according to Dr. Goldstein. “Many people with GI conditions are more in tune with their bodies than the average population, so they know what their body can and cannot handle,” he says. Hey, they don’t call it a gut instinct for nothing.
Still, anal may not be for everyone with IBS because of pain
Poop isn’t the only potential side effect of having anal sex with IBS. Sadly, there’s also the potential for pain. While there is a common misconception that anal sex is “supposed” to be painful, that’s actually not the case, says Dr. Goldstein. With adequate lubrication, pre-play, and anal training, receptive anal play should not be painful, he says. However, pain may not be avoidable for people with IBS for a few different reasons.
It’s common for people with IBS to have uber-tight anal sphincter muscles, says Dr. Goldstein. (Medically this is known as concomitant pelvic floor dysfunction). “When people spend their day fearing that they’re going to need to use the bathroom or have an accident, they end up squeezing their pelvic floors (which includes their anal sphincter muscles) all day long,” he explains. This consistent clenching can leave your sphincter muscles in a state of constant-contraction, which makes your hole so small and tight that penetration is simply not possible (even with a beginner butt plug).
Receptive anal sex can also be painful or uncomfortable if you’ve been going to the bathroom a lot, says Dr. Goldstein. “Going often can leave your hole sore, and in some instances chaffed from the toilet paper,” he says. If your stools were hard or especially hard to pass, it’s possible that you have collected microtears along the delicate anal tissues, he says. As you may have guessed, having papercut-like rips inside your anal canal can make anal sex feel very stingy, he says. Ouch!
What about douching before having anal sex with IBS?
ICYDK: An anal douche is a power wash for your anal canal. Anal douching involves pumping water (or a special solution) into the anal canal with a lightbulb-shaped bulb to rinse your rear clean of any lingering residue, explains Dr. Goldstein. This is a pre-sex step that can help boost confidence, he says, but it certainly isn’t necessary—even if you have IBS.
If you do douche, however, Dr. Goldstein recommends doing so with something called an isotonic liquid solution (like the Future Method Disposable Rectal Wash), which just means a liquid that has the same pressure and composition as the liquid in your cells—the fluids in IVs, for example, are isotonic. Using plain water, he explains, can mess with your anal microbiome and increase your risk for microtears from either pooping or penetration. “You also don’t want to over-douche,” says Dr. Goldstein. “If you use too much liquid or rinse too many cycles, you risk causing yourself unwanted GI symptoms like bloating and gas, which mirror the symptoms of IBS.” So follow the instructions on your anal douche carefully.
Exactly how to have anal sex with IBS
1. Talk to your doctor
Before you consider having anal with IBS, talk to your healthcare provider, suggest O'Shaughnessy. If you’re already diagnosed with IBS, odds are you have a go-to gastroenterologist who has helped you come up with a management plan. So, ring ‘em up and ask them if it’s safe for you to have anal, given your crop of symptoms, he says. No need to be shy—trust, they've heard it all.
2. Eat mindfully
As a general rule, what you eat when you have IBS is important. Well, it’s arguably even more important if you have IBS and are planning to enjoy receptive anal. You shouldn’t edit your diet without consulting your gastroenterologist, says O'Shaughnessy. But as a general rule, “you want to avoid consuming too much fat or too much caffeine ahead of anal play,” he says. Both can stimulate the gut and increase risk of unexpected and unwanted bowel movements.
Adding fiber and probiotic supplements to your daily routine can also help reduce the chances of an accident during anal sex, notes Dr. Goldstein. “Fiber is helpful because it bulks your stool and encourages complete bowel emptying, while probiotics help encourage a healthier digestive system overall.”
3. Don’t douche…during anal masturbation
“Most of us—even those of us with IBS—are actually ready at the drop of our pants to engage in anal sex, without having to do any douche to prepare,” says Dr. Goldstein. But if you'd like to have a trial run before testing out anal with a partner, not using a douche while you masturbate will allow you to see just how "ready" you actually are without a douche, he explains, adding that this should give you the confidence to have anal without douching first during any partnered play later on.
4. Boycott wet wipes
Anal play in your future or not, Dr. Goldstein recommends staying away from wet wipes. Wiping with wet wipes, he explains, can mess with the anal microbiome, cause irritation, and bacterial infection. If you have IBS, these additional peach problems can make anal sex even less comfy.
If your sphincter is more uptight than Brett and Marshall in the latest season of Love Is Blind, anal dilation exercises may help. “Using anal dilators can help stretch the skin and muscle in the anal area, as well as train you to relax those muscles” says Dr. Goldstein. Together, this can make anal entry more comfortable.
“The best part is the time commitment is nominal,” he says. “Just three to five minutes per session, two to three times a week is adequate to see major change.” You can even do it in the shower, which makes for easy clean-up!
6. Have a poop plan
Despite your best efforts, there is always some chance shit will happen. So, if you're going to have anal O'Shaughnessy says it’s best to expect the best but prepare for the worst. In practice, this looks like talking to your partner about the possibility ahead of play, keeping a towel within reach, and doing it on a blanket you don’t care about.
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