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Anal Douching – 7 Things You Need to Know!

Anal douching is the act of cleansing the anal canal and can be done in a variety of ways with a range of products. Many use anal douching to prepare for receptive anal intercourse, however, while it does help with cleaning the area, it is not strictly necessary for anal intercourse.

The anal canal is situated just beyond the rectum, its surface is lined by mucosa layer that amongst other functions, prevents the entry of infective agents such as bacteria into the underlying tissue. Another important structure of the anal canal are the anal sphincters, these muscles line both sides of the canal and maintain fecal continence (keeping your poop in).Tears in the mucosa layers can become infected very quickly, as these wounds further develop into abscesses, they ulcerate through the deeper layers of the anal canal and if the sphincters are damaged, can result in fecal incontinence. 

Overzealous cleansing – too hard or with harsh chemicals results in the mucosal lining of the anal canal to dry out. Dry tissue is “friable” meaning it breaks apart easily thus pre-disposing the anal canal to infection. Therefore, much like how scrubbing your hands with steel wool can give you blisters, anal douching is not entirely bad but must be done in a measured and safe way.

Is douching necessary for Anal intercourse?

No. Clearing your bowels before anal intercourse is useful in keeping your sheets clean and because most bowel movements are able to clear the rectum (the body’s poop storage pouch), gentle cleaning of the external anal canal will suffice in most cases. 


Are laxatives recommended when preparing for anal sex?

Not generally. Laxatives are designed to clear the entire colon which is approximately 1.5 m long. Generally, anal intercourse involves the anal canal (~4cm) and rectum (~15cm), which works out to approximately 20 cm of length or 10 inches (the law of averages would suggest that it enough space for most anal intercourse). A downside of using laxatives is that it can dehydrate you because it pulls water from your body into the colon to give “soften” the contents of the colon. 


Enemas for anal douching?

Enemas for emptying out the rectum and anal canal. It can be seen as a more focused means of cleaning out the area compared to Laxatives. There are however several concerns with enemas.

Firstly the solution used in the enemas can change the chemical balance in that area of your body. This can dry out the mucosa and predispose to damage. The tip of the enema should be soft and insert gently, this will prevent inadvertently tearing the mucosa with the tip of the enema. And lastly, do not share your enemas, studies have found that sharing enemas is a risk factor for the transmission of Sexually Transmitted Infections.


Is using water the best option to clean out your anus?

Yes. Water is generally pH neutral and is not as caustic to the mucosa as some of the chemicals in enemas. Again be careful when inserting anything into your anal canal!


Does over-douching cause you to poop?

Depending on how you do it but generally no. Douching itself is different from laxatives in that it only clears the poop in your anal canal and rectum. 


How long should anal cleansing take?

Anal cleansing should take about 5 – 10 minutes. Again, like washing your hands, overzealous washing can damage the tissue and make it friable. A good bowel moment and gentle washing if the area with water should suffice in getting the area clean.


Does anal douching increase the risk of HIV/ STDs?

Potentially. As mentioned, sharing enemas is a risk factor for contracting STDs even after washing the tip. Because most STDs infect by entering the body through a break in the mucosa, any damage to that layer either by overzealous washing changing the chemical balance of the tissue making friable or mechanical damage with a pointed enema tip create entry points for infective agents that cause STDs to enter the area. To further minimize the transmission of STDs during Anal Intercourse it is hence best to wear a condom.

Also read: Vaginal Douching


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Rectal Douching and Associated Infection Risks

Similar to vaginal douching, rectal douching or anal douching is not something that many people talk about it polite circles. It is commonly practiced by Men-Who-Have-Sex-With-Men (MSM) who receive anal sex. Let’s face it, generally we don’t want our loved ones to have to deal with our faeces while having anal sex. However there is a growing concern about the practice of performing anal douching and its associated risk of STI including HIV infection.
Other Read: Anal Pap Smear for Anal Cancer.
 

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A recently published systematic review (essentially this means that the study involves gathering all published studies on a subject and compiling the findings together) in the journal Sexually Transmitted Infections (May 2019), there is evidence to suggest that anal douching can potentially increase the risk of STI and HIV infection among MSM. In the systematic review, it included a total of 28 studies looking at anal douching and the risk of STI/ HIV in MSM population around the world (46% from US, 35% from Europe and the rest from South America, Asia and Africa). 
Also Read: STD Risk From Receptive Unprotected Anal Sex In Men
 


The findings show that men who perform anal douching compared to those who don’t have a 2.8 times higher risk of HIV and close to 2.5 times higher risk of any other types of STIs (Hepatitis B, Hepatitis C, chlamydia, gonorrhoea, syphilis and HPV). With respect to specific STIs, the study found that anal douching increases the risk of chlamydia and gonorrhoea by up to 3.25 times and 3.29 times for Hepatitis B Virus and Hepatitis C Virus.
It is theorised that possible reasons for the association of anal douching with increased risk of STIs and HIV may be due to:

  1. Water and/ or soap causes the delicate lining of the rectum and intestines to become damaged.
  2. Removal of normal flora (bacteria that normally is found in the rectum) due to the action of flushing
  3. Risk of transmission of STIs and HIV through the sharing of douching devices much sharing of needles for IVDU. 

 


The authors also noted that further studies will be needed to further elucidate this association between anal douching and STIs and HIV infection.
Speak to your doctor if you have any questions regarding the associated infection risks from rectal douching or anal douching.
 


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