Anal Fissures in Gay Men

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Hey there, it’s Tom of P-Town back with another installment of our health and wellness series. Today, I want to shine some light on a topic that can be, well, a real pain in the butt: anal fissures—particularly as they relate to gay men.

Why Gay Men?

Anal fissures can affect anyone, but in gay men who engage in receptive anal intercourse, there’s an added risk factor. The delicate skin around the anus can develop small tears (fissures) due to friction during sex, constipation, or even passing especially hard stools. Because anal play and intercourse can increase friction, these tears may be more common for those of us in the gay community who enjoy receptive activities.

Symptoms to Look Out For

  1. Sharp Pain: Often described as feeling like passing shards of glass, with the pain peaking during or right after a bowel movement.

  2. Bleeding: Bright red blood on toilet paper or in the toilet bowl.

  3. Itching or Burning: Persistent itching or burning around the anus.

  4. Muscle Spasms: The anal sphincter can go into spasm, increasing pain and hindering healing.

If you notice any of these signs, you could be dealing with an anal fissure.

Home Care Tips

While fissures can be painful, mild cases often start to heal with proper home care:

  1. Sitz Baths: Soak in warm water for 10–15 minutes a few times a day to relax the anal sphincter and promote healing.

  2. Dietary Adjustments: Load up on high-fiber foods (fruits, veggies, whole grains) to soften stool and reduce straining.

  3. Stay Hydrated: Drinking plenty of water helps prevent constipation.

  4. Gentle Hygiene: After bowel movements, use mild soap or unscented wipes, and gently pat dry—avoid harsh rubbing.

  5. Stool Softeners: Over-the-counter stool softeners can help if your bowel movements are particularly firm.

  6. Lubrication & Relaxation During Sex: Adequate lube and relaxed communication with your partner can help prevent further tearing.

Dietary & Herbal Supplements

In addition to the basics of fiber and hydration, certain over-the-counter dietary and herbal supplements may support anal health and aid in fissure relief:

  1. Psyllium Husk (e.g., Metamucil): A gentle fiber supplement that helps keep stools soft and easier to pass.

  2. Slippery Elm: Known to soothe mucous membranes, it may provide relief by promoting healthy digestion and easing bowel movements.

  3. Aloe Vera Capsules or Juice: Aloe vera is often touted for its soothing and anti-inflammatory properties.

  4. Turmeric (Curcumin): This spice has anti-inflammatory effects that may help reduce discomfort and inflammation around a fissure.

  5. Omega-3 Fatty Acids (Fish Oil or Flaxseed Oil): While primarily used for heart health, the anti-inflammatory properties may offer mild support for tissue healing.

Always read labels, follow recommended dosages, and consult a healthcare professional before starting any new supplement—especially if you have other health conditions or take prescription medications. You can order these from my trusted dispensary and get a discount if you register here. 

When to See a Doctor

If the fissure is severe or doesn’t improve after a couple of weeks of home care, it’s time to seek professional help. Ideally, find a primary care doctor or proctologist familiar with LGBTQ+ health—someone who understands our unique needs and concerns. They’ll evaluate the fissure, rule out other causes (like hemorrhoids), and suggest the best advanced treatments.

Medical Treatments to Know

  1. Prescription Ointments/Creams: One common first-line medical treatment is a compounded calcium channel blocker cream (e.g., diltiazem or nifedipine). These help relax the anal sphincter and improve blood flow for faster healing.

  2. Nitroglycerin Ointment: Reduces anal sphincter pressure and promotes healing.

  3. Botox Injections: Temporarily relax the anal sphincter, giving the tear time to heal.

  4. Surgery (Lateral Internal Sphincterotomy): A last-resort option that involves a small surgical incision to relieve sphincter pressure.

Final Thoughts

Anal fissures are no joke, and they can be especially stressful if you’re sexually active. But remember, you don’t have to suffer in silence or let a painful fissure interfere with your sex life or quality of life. Early attention—through home care, potential dietary or herbal supplements, and consultation with an LGBTQ-friendly healthcare provider—can make all the difference.

Until next time, this is Tom of P-Town reminding you: a happy bottom is a happy life!


References

  1. American Society of Colon & Rectal Surgeons. (2021). Anal Fissure. Retrieved from ascrs.org

  2. Mayo Clinic Staff. (2022). Anal fissure. Mayo Clinic.

  3. Cleveland Clinic. (2022). Anal Fissure: Symptoms, Causes & Treatment.

  4. National Institutes of Health (NIH). (2021). Dietary Supplements in the Time of COVID-19.

  5. Healthline. (2021). Anal Fissure: Causes, Symptoms, and Treatments.

Disclaimer: The information provided here is for educational purposes and should not replace professional medical advice. Always consult a qualified healthcare professional for an accurate diagnosis and personalized treatment plan.

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