Crohn's disease and anal sex

Dear Alice,

I have been diagnosed with Crohn's disease and am a gay man. Is it harmful to have anal sex under normal circumstances?


Dear Reader,

It's amazing how one spot can be both the source of so much pleasure and also so much discomfort. Frustrating to say the least, but it's great that you are making the most of your situation while keeping safety in mind. The best option for you to receive anal sex in both a safe and enjoyable way in light of your Crohn's disease is to treat the symptoms and avoid exacerbating them when they flare up. This will not only help you on a regular basis, but may also prevent anal penetration from worsening the discomfort your condition is no doubt already causing you. In addition, practicing safer sex by using condoms and other barrier methods will help you to stay safe and healthy.

Long-term effects of Crohn's disease (a chronic condition that causes inflammation of the gastrointestinal tract) vary, but may include ulcers (open sores) in the parts of the bowel affected by the disease and other areas including the mouth, genitals, and anus. People with Crohn's disease often have difficulty passing stools, which may cause "anal fissures", or small cracks in the anus and surrounding skin. This increases the risk for STI transmission during anal penetration for both men and women. This underscores the importance of using protection and lubrication during sexual intercourse, especially for people such as you who have extra sensitive genital/anal tissue.

The good news is that there are a variety of treatments for Crohn's disease that help reduce the symptoms that may make anal sex uncomfortable and/or harmful. A health care provider may prescribe anti-inflammatory drugs, immune system suppressors, or antibiotics to lessen or alleviate symptoms such as ulcers, bloating, abdominal pain, and nausea. You may also want to try these at-home remedies:

  • Acetaminophen to reduce pain and inflammation (avoid using aspirin and ibuprofen as they may actually worsen symptoms)
  • Limit intake of dairy and fatty foods (common aggravators of Crohn's symptoms) and any other foods that you find are particularly troublesome for your digestive system
  • Drink plenty of water and avoid caffeinated and carbonated drinks that may worsen symptoms
  • Eat smaller meals to lessen the strain on your digestive system
  • Consider taking multivitamins to replenish nutrients that your body may have difficulty absorbing as a result of Crohn's disease
  • Reduce stress that may trigger flare-ups

            List adapted from Mayo Clinic.

With the help of a health care provider, often a gastroenterologist and/or nutritionist, you can explore these suggestions and others which may help keep the symptoms of Crohn's disease under control. Until then, it is advisable to avoid anal sex during flare-ups. By doing this, you may be able to decrease the discomfort you experience and also increase your chances of remission.

Remember though, sex should not be painful and if it is, you and your partner may want to consider other options for pleasure. This could be a great start to a conversation about what turns you both on and how you two can work with your limitations to achieve the maximum amount of pleasure. Sex does not always have to involve penetration, so take this opportunity to get creative and explore new ways to get it on. Oral sex? Mutual masturbation? Sensual massages? The possibilities are endless.

Last updated Jul 06, 2015
Originally published Apr 22, 2011

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