Bottoming with IBS

Dr. Evan Goldstein

fundamentals June 07, 2023

People with GI disorders may feel like anal receptive sex is something they’ll never be able to engage in. However, bottoming with IBS is not only possible, but it can be enjoyable, too. In this guide, I will discuss how to navigate anal sex and GI conditions so that you and your partner(s) can enjoy everything that bottoming has to offer.

What is IBS?

Irritable Bowel Syndrome, or IBS, is a group of symptoms that occur together, including repeated pain in your abdomen and changes in your bowel movements, which may be diarrhea, constipation, or both.(1) Unfortunately, for a lot of people, IBS is a generic diagnosis when no root cause can be identified. 

If you suffer from IBS and are interested in having anal receptive sex, it’s important to sit down with your doctor to create a game plan to try and help control symptoms (or at least be able to navigate around them). This process starts with understanding which foods and drinks, as well as certain stressors and situations, cause gastrointestinal distress. For example, you may find traveling, or big meetings, or other stressful events can affect your bowel movements. The most common way to figure this out is by keeping a food journal, as well as making note of these particular situations. Hopefully, you and your doctor will start to see patterns, which will then allow you to say, “I should avoid these foods and drinks when I plan on having anal sex.” Unfortunately, IBS doesn’t have a cure and it can present itself at random times (like right when you want to have anal sex), but staying away from your triggers is a good way to try and avoid negative symptoms that can get in the way of your sex life.

Other GI Conditions

While IBS is most common, there are other GI disorders, as well as anal and rectal issues, that can affect anal sex, including inflammatory bowel disease (IBD), hemorrhoids, anal fissures, anal abscesses and fistulas, and proctitis. These conditions can cause pain, discomfort, bleeding, and other serious issues, and should be addressed with your doctor before engaging in anal receptive sex.

How Does IBS Impact Anal Sex?

IBS can impact anal sex by:

  • Causing symptoms such as abdominal pain, bloating, and diarrhea, which can make anal sex uncomfortable or even painful
  • Causing anxiety or stress, which can affect sexual desire and enjoyment
  • Needing to prepare carefully before anal sex by taking medication or eating specific foods to manage their symptoms

Receiving anal penetration may be painful for those with IBS when their sphincters are too tight (officially referred to as concomitant pelvic floor dysfunction). People with IBS-D (D for diarrhea) spend their day fearing they’ll have to use the bathroom, which causes them to squeeze and hold their pelvic floor, leading to spasms. Believe it or not, this actually perpetuates the problem. That’s where anal dilation exercises can help by strengthening and stretching the skin and muscle in the anal area enough that you can experience pleasure instead of pain, as well as better bowel movements. Fortunately, these exercises can easily be integrated into your weekly routine, requiring only 3-5 minutes each session, 2-3 times a week. I find the shower is the best place for dilating because the warm water and steam help relax the body and mind, while cleanup is a breeze. Additionally, at my private practice, Bespoke Surgical, I utilize anal Botox in qualified candidates to help relax the sphincters and pelvic floor, allowing people who suffer from overly tight skin and muscles to fully empty during defecation (as well as be able to bottom more easily). This then leads to less contractility during the day, and less IBS symptomatology. 

Other times receptive anal sex may be painful or uncomfortable if you’ve been going to the bathroom quite frequently and your butt is feeling sore or chaffed from all the wiping. You might even have a micro tear without knowing it, and then having sex can make it worse. Also, try using Future Method’s Butt + Body Soothing Cream locally to help moisturize and soothe the skin, and stay away from wet wipes at all times, both of which will help to reduce any dermatitis.

How to Prepare for Anal Sex with IBS

You’ve decided you want to give anal sex a try, and now you’re wondering how best to prepare your body–and mind–for what’s to come. Here are a few tips to get you and your partner ready:

  • Communication with your partner about your IBS symptoms and any concerns you may have is essential. By understanding your body and the sometimes unexpected symptoms that IBS can present, you’ll be able to better manage your expectations. It’s also important to find a partner(s) who is compassionate and empathetic. 
  • You may want to prepare your body for bottoming by taking medication, ensuring you’re properly hydrated and consuming adequate fiber, and using isotonic anal cleansing formulas to properly douche with.
  • Consider finding your most comfortable position that may be needed and don’t be afraid to take breaks. 
  • Listen to your body, use relaxation techniques to manage any discomfort, and, if needed, call it quits for that session. As soon as you feel pain, that’s your body telling you not to go any further. If symptoms persist, contact a medical professional if you feel the need to.

Douching with IBS

If you want to give yourself an extra boost of confidence that there won’t be any surprises during anal play, then, yes, they can absolutely anally douche beforehand. However, don’t overdo it. What most people don’t understand is that when they over-douche (i.e. with larger volumes of liquid and/or too many rinse cycles), they typically end up causing an increased amount of negative GI symptoms. Therefore, I recommend using a small reusable bulb and an isotonic and iso-osmolar liquid, which means it's compatible with your body and won't cause irritation. I developed one for my company, Future Method, because so many people were using homemade solutions, which end up wreaking havoc on the body. With the appropriate solution and methodology, whether you have IBS or not, you'll experience better bottoming and overall success. Also, stay away from anal enemas. It’s a common misconception that a douche and an enema are the same; however, enemas are truly meant to elicit a bowel movement when suffering from a severe case of constipation, something those with IBS-C suffer from, or to help get you ready for a medical procedure, like a colonoscopy. Prepping for anal play should only focus on cleansing the lower portion of the rectum, to get rid of any lingering fecal matter, which is what a douche is for.

Also, in addition to proper diet and douching techniques, adding fiber and probiotic supplements to your daily routine can help because IBS and alterations in the microbiome may go hand-in-hand. Fiber is helpful because it bulks your stool and encourages complete bowel movements, while probiotics help encourage a healthier digestive system and anal microbiome. That’s why Future Method developed a unique pre- and probiotic blend that helps optimize healthy digestion in people who engage in receptive anal play.

IBS and Anal Sex Doesn't Need To Be Feared 

The combination of anal sex and IBS doesn’t need to be your worst nightmare when you know how to properly prepare for it. Remember that open lines of communication, the right preparation routine, and working with your doctor to help manage your symptoms are key when it comes to enjoying anal sex with IBS. If you're looking for high-quality products that can help you prepare for and enjoy anal sex with confidence, check out our shop for things like our Anal Douche set.

About the author

Dr. Evan Goldstein is the Co-Founder of Future Method and the Founder and CEO of Bespoke Surgical, the leading private practice in health and wellness for gay men. He received his MD from the University of Medicine and Dentistry School of Osteopathic Medicine. Dr. Goldstein is the go-to butt and bottoming expert, having been published in Huffington Post, Men’s Health, Healthline, and more. Learn about Dr. Goldstein by visiting his practice, bespokesurgical.com.

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