Care Before And After Anal

  • For people with digestive diseases like IBD (Inflammatory Bowel Disease) including Crohn’s disease and ulcerative colitis and IBS (Irritable Bowel Syndrome), aftercare following anal sex (bottoming) is especially important to support healing, minimize irritation, and prevent flares or complications, and just as importantly, to connect with your partner and have a positive experience all around, mentally and physically.

  • Bottoming with IBD takes communication, compassion, and body awareness but it’s possible and can be deeply affirming, but care and intimacy doesn’t begin or end at penetration!!

  • It’s important to respect your whole self and remember you are worthy of sex that’s safe, connected, and joyful.

When we talk about bottoming, we often discuss preparation (aka the three Ds: dieting, douching, dilating), but we rarely mention what to do after engaging in anal sex.

As fantastic as it is, anal sex can be traumatic to the body if we don’t take care of ourselves before, during, and after.

Before

Physical

  • Know your IBD status. Bottoming is safest when your symptoms are stable, no active bleeding, severe urgency, or severe recent flare.

  • Empty your bowels naturally (without overdoing it): If needed, some use a small, gentle bulb enema with plain warm water , but use precaution and don’t bottom during a severe flare or if you have active severe rectal inflammation, weeping fissures, or other complex perianal disease.

  • Lubricate generously. Use plenty of high-quality, water-based or silicone lubricant to reduce friction and microtears.

  • Avoid irritants. No harsh douching, soap, or scented wipes. These can strip natural oils and irritate delicate skin.

  • Breathe and relax. Deep breathing, pelvic floor release techniques, or warm compresses can help muscles relax.

Emotional and Psychological

Affirm your body. Remind yourself that your body deserves comfort and pleasure, even with IBD - and especially with IBD!

  • Communicate clearly: Let your partner know how you’re feeling and what feels good vs off-limits today.

  • Establish safe language: Use check-ins or a safe word to pause or slow down.

During

Physical

  • Go slowly. Take your time with penetration, especially if coming off of a flare or if having recent symptoms. More patience leads to less pain and injury (and love is patient :)

  • Listen to your body. Stop or shift positions if anything feels sharp, crampy, or “not right.”

  • Use more lube if needed, and if you think you have enough, you probably need some more. Dryness or friction can worsen inflammation or irritation.

  • Protect against infection. Use condoms if you or your partner(s) are at risk of STIs (immunosuppression, recent antibiotic use, etc.) or are with a new partner(s) especially with rectal inflammation.

Emotional

  • Pause for connection. Check in mid-way: “How are you doing?” or “Do you want to continue?”

  • Safe words. Coming up with a safe word to use if you need to stop, or just having open communication with your partner(s) if things get uncomfortable such that you need to stop or pause.

  • Aim for pleasure, not perfection. There is no “right” way to have sex. It’s okay to stop, laugh, or shift the vibe.

  • Normalize body moments. Farting, lube leaks, or muscle twitches? All normal. You are not broken, and it’s important to normalize being in the moment and that none of our bodies are going to be 100% perfect all of the time, and that’s okay.

After

Physical

  • Clean gently. Use warm water, a soft cloth, or unscented wipe. Pat dry.

  • Soothe sore tissue. Try a sitz bath, aloe-based cream, or barrier ointment if irritated.

  • Rest your bottom! Avoid more anal play for a day or more if sore.

  • Watch for symptoms. Mild soreness is normal. But if you notice bleeding, pain, urgency, or mucus, contact your provider.

Emotional and Psychological

  • Debrief kindly with your partner(s). Ask each other: “What felt good? What would you change next time?”

  • Offer reassurance. Especially if there was discomfort, urgency, or anything unexpected.

  • Express care. Cuddling, sharing a snack, or holding each other can be healing after vulnerability.

  • Remember! IBD doesn’t make you less desirable. Your needs, limits, and pleasure matter.

aftercare for your bottom: extended version

  • After you’ve bottomed, the area will be more sensitive than usual, so run a nice warm bath, spill in some Epsom salts, and bliss out.

  • The warm water and Epsom salts will quell the area and relax your muscles. This makes for an opportune time to replay those moments in your mind and clean the area.

  • While a gentle soap will do the trick, you can be extra and purchase a bum exfoliator to clean and buff your booty hole.

  • If you’re still feeling a little raw after your bath, you can take a tylenol (acetaminophen/apap) to help with inflammation.

  • If after four or so hours, pooping hurts, try using CBD oil, an anal numbing solution, a lidocaine or benzocaine cream like Americaine (see here) or just regular dental numbing gel like Anbesol.

  • This will lessen the pain while your hole recovers from the pounding.”

  • After you’ve pooped, inspect the stool for blood. It can be hard sometimes to differentiate between IBD blood and blood from other sources - but this blood will likely be bright red since it is from the capillaries in the anorectal area.

  • A little bleeding can be expected from time to time, but excessive pain, bleeding, or discharge should not, and you may want to consult a physician.

  • If you experience of these symptoms (due to bottoming), take a break from anal intercourse until they’re gone.

  • This can take anywhere from a few days to a week to heal. In the meantime, let your healthcare provider know, make sure you are being gentle with yourself and taking care of your body, and drink plenty of water, so bowel movements are as smooth as possible, and take a sitz bath three to four times a day to keep the area clean.

  • For good measure, use this time to consider how things can be done more carefully next time.

  • You may also want to reevaluate how you clean yourself after a bowel movement, since wet wipes are no good for your rear, especially if you engage in regular anal intercourse.

  • Due to their ingredients, their moisture, and their material, wet wipes can irritate and even infect your precious booty hole.

  • Toilet paper can be similarly abrasive, especially when you wipe instead of blot (and depending on the brand, and ply - after you go 4 ply and above you really are changed for life)

  • That’s why you using a bidet can be really helpful. They’re a bottom’s best friend (and IBD and IBS too) and offer a spa-like experience for your butthole.

  • To keep your butt in tip-top shape, do some Kegels (talked about here, and more in depth about pelvic floor physical therapy here) to tighten your pelvic floor and keep everything strong (not just good for bottoming, good for pelvic floor strength in IBD too!)

  • Just insert a toy into your bum, flex, and repeat, it’s as simple as that.