Dear Alice,

My professor was giving a lecture today about oral stimulation and she brought up anilingus. She said that the risk for contracting unwanted bacteria is high. I know that dental dams can be used, but how effective is a good washing before anilingus to rid you or your partner of bacteria?

Dear Reader,

As your professor said, anilingus (also known as "rimming" or anal oral sex) — kissing, sucking, licking, tonguing the anus with the lips or tongue — presents a risk of getting or spreading potentially harmful bacteria. If someone ingests these germs, they may experience symptoms such as fever, cramping, and diarrhea. Intestinal parasites and sexually transmitted infections (STIs) such as herpes, gonorrhea, human papillomavirus (HPV), human immunodeficiency virus (HIV) and hepatitis, which can infect the anus, also present a risk. It's also possible to be exposed to blood if there are cuts or tears in the anus, or any traces of bloody feces, which heightens the risk of bloodborne illnesses and infections. While a good washing can help "freshen" the area before anilingus, it won’t necessarily "rid" the area of germs and doesn't reduce the risk of spreading or contracting STIs. Therefore, as you mentioned, when rimming, a latex barrier, with a dab of lube on the side covering the anus, can reduce risk for both partners.

In most cases, as long as fecal matter is well-formed (not too watery or too hard), it doesn't spend time in the rectum and anal canal until right before a bowel movement. This means that, as long as someone is avoiding engaging in anal play when they need to use the bathroom, large messes are unlikely. However, people who have regular bowel movements generally still have trace amounts of feces in the canal. Before rimming, some people wash the anus with a moist, soft cloth to be sure that the area is as clean as possible. It's preferable to choose gentle products that won’t irritate the anus or cause cuts and possible infection.

Some people use a mild enema, which releases warm water into and then out of the anus to initiate a bowel movement, or clean out any traces of feces and bacteria from the anal cavity. Some options use chemical laxatives to help expel everything in the rectum, while others simply use warm water. In any case, these liquids are inserted into the rectum to help clear out the anal cavity. Using an enema two to three hours before anilingus allows the body some time to reabsorb the water before the activity takes place. It’s worth noting that frequent use of enemas can disrupt the rectum, bowels, and gastrointestinal tract and the disturb body's own elimination rhythm. It’s also good to use warm water without soap as it’s the least likely to irritate the anus. Additionally, some research has shown that enema use may be associated with increased STI risk as it may damage the tissues around the anus, which can help facilitate transmission. 

In addition to preventing bacterial infections, it’s also good to take precautions against STI transmission (some of which are also caused by bacteria). In combination with barrier methods, ensuring that both partners are regularly screened for STIs can be a useful prevention measure. A person who engages in anal play or anal sex may want to inform their health care provider so they can receive rectal testing for STIs, as anal STI infection won’t be detected through specimens tested from the vagina or urethra. While the recipient is at some risk, the partner with the active tongue is more at risk of contracting an STI. However, if the giving partner has a cold sore or has blood, semen, or vaginal fluid in their saliva and there are cuts around the anal opening or in the anus through which bacteria and viruses can enter, the receiving partner may be at an increased risk.  

Whether you’re trying to prevent bacteria or STIs from spreading, some safer sex barrier options include using a dental dam or a dry condom with the tip and elastic ring removed and cut along the length. Balancing safer sex measures, hygiene, and personal preferences with rimming can get a little messy, but with some key information, each individual can find a way to make anilingus fun and safe for all partners. 

Alice!

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