Irritable Bowel Syndrome (IBS) and Bottoming, Sex, and More
Sometimes people have IBD and IBS, or IBS and not IBD - or just have questions about IBS and anal sex/bottoming or LGBTQ health in general. It is not scientifically proven, but some people say that hot people have tummy issues, (the TikTok trend of #HotGirlsHaveIBS did a lot for that one) that does not mean you don't have to be without answers to questions! (you can be hot without tummy issues too, being attractive and digestive issues are not mutually exclusive).IBS and Bottoming
Not all IBS is made the same, so this is where things get a little tricky.Some people have IBS-C, IBS-D, some people have have specific dietary restrictions, etc. so this is far from a one-size-fits-all approach and will likely need to be modified according to your body’s needs and what you can handle.It’s also okay if not everything works out the first time, or if you take a while to find what works.
Like Latrice Royale said on RPDR, It’s okay to fall down. Get up, look sickening, and make them eat it! (not literally, that would be a little unsanitary)Some people try the “less is more” technique by "fasting a little bit before bottoming with IBS so there’s not as much to poop out (honestly not even exclusive to IBS).
Bottoming may be painful for those with IBS when their sphincters are too tight (concomitant pelvic floor dysfunction).
People with IBS-D who may be vigilant over daily fears over when/if they’ll have to use the bathroom, are led to squeeze and hold their pelvic floor, leading to spasms.
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.
These exercises can easily be integrated into your weekly routine, requiring only 3-5 minutes each session, 2-3 times a week - the shower is a good place for dilating because the warm water and steam help relax the body and mind, while cleanup is a breeze.
If you live with IBS and are interested in having anal receptive sex/bottoming 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).
You don’t have to say “Hi, I want to control my bowel movements for sex”, you can just have a conversation about symptom control for your overall quality of life and like, work, hobbies, going to the park or something.
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 and symptom journal, as well as making note of these particular situations.
Hopefully then you will start to see patterns, which will then allow you to say, “I should avoid these foods and drinks when I plan on bottoming.”
Unfortunately, IBS doesn’t have a cure and it can present itself at random times (like right when you want to bottom), 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.
With IBS (and IBD, and everything really) you don’t want to over-douche.
This may lead to your tummy hurting later as it causes a lot of GI discomfort/negative GI symptoms.
Use a small re-usable bulb and isotonic or iso-osmolar liquid .
Isotonic/isoomolar liquids will be compatible with the salt and pH content of your body’s fluids and intestinal lining and stuff and will be less uncomfortable in the long run here - iso means same)
Fleet is HYPERtonic (it’s saline, so it DRAWS the water out of your rectum/etc)
Prepping should really only focus on cleaning the bottom portion of the rectum (unless you’re doing something else, then that’s a different discussion) so a douche getting rid of fecal matter lingering around there is sufficient.
A daily probiotic (I eat yogurt instead of taking it as a pill) and fiber is also good - but again, some people can’t handle fiber like other people can.
Also, companies market fiber supplements to bottoms - DON’T FALL FOR IT! They are soooo overpriced, and the same thing as any fiber supplement you get at the pharmacy.
Just get a psyllium husk supplement and don’t buy something that is marked up 500%.
A probiotic will help keep your microbiome all good and healthy, encouraging a healthy anal microbiome and digestive flora (we love the microbiome!) and the fiber will help bulk your stool up.At the end of the day, IBS and bottoming aren’t something that should be terrifying and off limits, just something to know how to navigate.Learn your body and listen to your gut (literally) and rest on your bad days, and have fun on your good days.
TLDR: There is no rule anywhere that says you cannot have anal sex if you have IBS. You can have anal sex/bottom.
Sexual Dysfunction and IBS
IBS can impact anal sex/bottoming and overall sexual dysfunction, causing symptoms such as abdominal pain, bloating, and diarrhea, which can make anal sex uncomfortable or even painful and not desirable at the time.
Bottoming may be painful or uncomfortable if you’ve been going to the bathroom a lot (IBS-D) and your butt is feeling sore or chaffed from all the wiping.
You might even have a micro tear without knowing it, and then bottoming can make it worse.
IBS and it’s symptoms can also cause 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
Several studies have suggested that people with IBS experience sexual dysfunction.
People often report that “because of (IBS) bowel problems, sexual activity is difficult for them” and “My bowel problems reduce their sexual desire".
This includes reduced sex drive/libido, erectile dysfunction, and painful intercourse.
IBS, and the symptoms with it, might also make you feel anxious and depressed – two emotions that can affect sex drive.
These are VERY IMPORTANT things to bring up with a trusted medical professional!
It doesn’t have to be your gastroenterologist - it can be a community health clinic, sexual health clinic, your PCP, any of your healthcare team that takes care of you.Their main goal is making sure these things are taken care of and you are doing well - and sexual health issues with IBS are very common and they are prepared and know just how to address it.If IBS is affecting your sex life, talk to your doctor about other treatments and potentially bring your partner(s) or include your partner(s) if you feel comfortable doing so.
Don't feel embarrassed or anything to bring it up - sexual dysfunction is very common in IBS, and they are adults (as you are an adult) and to them - it's just another part of the day.
You might also consider joining a support group for people coping with IBS, and see if there are LGBTQ+ IBS support groups in person or on social media to join (more likely to be found on social media, if I’m being honest).
Relationships and IBS
A lot of the same principles as with IBD and information from this page applies here
If you’re in a new relationship, you may wonder about the best time to tell your partner(s) about your IBS and how it affects you.You don’t necessarily have to say anything at first
This is your life, and you are under no obligation to disclose your personal health information if you don't want to.
You are an independent person so do what makes you comfortable, (personally I don't disclose my PHI on the first date)
As you and your partner(s) get to know each other and share more personal details about your lives, and you explore them being with you on a long-term basis and being with you throughout your IBS/IBD/everything journey, you can bring up the subject.Chances are, your partner will be supportive. And if they aren’t - that’s water off a duck’s back! Not the person for you.Let your partner(s) know how you’re feeling, emotionally and physically.For example, if you’re feeling embarrassed about your symptoms or anxious that sex (or any activity) will trigger them, it’s okay to tell your partner(s).
They will likely reassure you. And if you’re in the midst of an IBS flare-up, you just might not feel up to having sex.Explain that to your partner(s), too. And if they don't listen or pressure you any further - that is not the person for you.
You deserve someone who respects your boundaries, comfort, and health - guts and all.