Anal protrusion after anal sex

Dear Alice,


Here is my situation: My b/f and I had anal sex, and this was not the first time we've done it. But this time was different. After we were done I noticed there was something that kind of just popped out from my bottom. It's like a piece of your skin or muscle or something. I kept trying to push it back in, but it keeps coming back out. It doesnt cause me great pain, but just a little bit of itching sometimes. What is it? What should i do with it? Is it bad? Please let me know. Thank you.

Dear Reader,

It can be rather disconcerting to see some unidentified body part protruding from your behind. There are two likely possible explanations: it could be an internal hemorrhoid or a rectal prolapse. In either case, you would want to visit a health care provider to find out for sure and get treatment.

First, a basic anatomy lesson of the southern region: The large intestine (colon) empties its contents into the 10 to 15 cm bowel, which is the rectum. There, stool sits held in place by a complex set of highly sensitive ligaments and muscles until it is released into the anus and excreted out of the body. These muscles are not very strong and are easily stretched, torn, or weakened. Many things can weaken these muscles, including chronic constipation, childbirth, and even lifting heavy objects while holding your breath. Anal penetration can also weaken these muscles over time, especially if you’re being penetrated by a large object, such as a large penis or a hand, like in anal fisting. When these muscles are weakened or damaged, fecal incontinence can result, but also rectal prolapse or hemorrhoids.

Hemorrhoids occur when blood vessels in the rectum and anus become irritated and swell, stretching the walls of the rectum and anus. They are sometimes painful, depending on the type of hemorrhoid. Internal hemorrhoids lie deep in the rectum and they don’t usually hurt because there are few nerves that far back. But sometimes internal hemorrhoids enlarge and protrude outside the anal sphincter. This may be what happened in your case. If so, what you are seeing is a moist, pink pad of skin that is pinker than the surrounding area. Prolapsed hemorrhoids sometimes hurt because the anus, unlike the rectum, is dense with pain-sensing nerves. They sometimes recede into the rectum on their own or can be gently pushed back into place. But they may not always stay put, as you’re noticing.

A more serious condition is called rectal prolapse. This occurs when the muscles holding the rectum in place weaken enough that gravity starts to pull the rectum downward. If this is what you have, the protrusion is larger (approximately the size and shape of a small sock), moist, and pink. For some with rectal prolapse, the protrusion only occurs during bowel movements, but for others it may be present all the time.

Treatments depend on your age, health, and the severity of the hemorrhoid or prolapse. There are some basic self care things that can help treat hemorrhoids, including eating a high fiber diet (which can also be preventative), not standing or sitting for long periods, daily warm baths, and anorectal lubricants to help ease pressure during bowel movements. In addition, there are medications and surgical treatments that are very effective and allow for a quick recovery. Rectal prolapse is usually treated with surgery, along with stool softeners and other medications to help support healing.

Both situations can become serious if untreated, so you should see a health care provider. Moreover, consider avoiding anal sex until you see your health care provider and get treatment. If anal sex is something you really enjoy and choose to resume after treatment, consider asking your boyfriend to penetrate you with a smaller object such as a butt plug. Make sure you are using plenty of lube and always stop if you experience any pain. If your boyfriend really enjoys anal sex, consider finding other ways for him to get off or consider having him penetrate you less deeply and for less time. Going a bit easier on your anus will help preserve those muscles as you age and avoid further health complications later.

Take care,

Originally published Jul 10, 2015

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