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Dr. D. Love
Dr. D. Love, Doctor
Category: Medical
Satisfied Customers: 18448
Experience:  Family Physician for 10 years; Hospital Medical Director for 10 years.
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Hi, I am suffering from constipation after having anal sex

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Hi, I am suffering from constipation after having anal sex about 1 month ago. I do not have anal sex often maybe once every two months and have had episodes of constipation afterwards before but never for a period more than one week and this has been one month and is showing no signs of improvement. I saw a gastroenterologist who did a metabolic panel and other blood work which turned up no abnormality. He is having me take a OTC laxative called Marilax which is working poorly. I am jot interested in a laxative I want to know if I may have damaged myself during the anal sex and what I need to do now. I did not tell the gastroenterologist about the anal sex because I was embarrassed. My main questions are
1. Have you heared of such an injury from anal sex causing long term constipation from a single incident? (Note that I am experiencing no pain nor was I ever and no blood in stool.)
2. Do you think this will heal or resolve on it's own?
3. Are there any tests that I should get?
4. Do you have any idea what may be causing the constipation? I am assuming it is related to the anal sex because it began right after.

Other relevant information

no drugs.
No experience with constipation like this in my past only small periods maybe 4 or 5 days and never this bad.
No illness or conditions.
Physically very fit, height 6. 2 weight 170

This situation is very disturbing for me and any help/ information/ advice/ diagnosis you may provide me with would be very much appreciated.


Anal sex does not directly cause long-term problems with constipation, as the consistency of the stool is determined long before it gets to the anus. It is possible to have anal problems that develop from anal sex, such as anal tears or local infection. If one of these problems causes anal pain or other symptoms, then there can be a subconscious reaction to avoid having a bowel movement, and holding the stool in as long as possible can lead to constipation. If this were to happen, there would be pain or other symptoms that would be contributing to the development of the constipation. In this situation, time will heal some of the problems (such as tears), but specific treatment may be necessary for others (such as antibiotics for infection). However, since you have never had any pain or other symptoms, this would be unlikely.

There are many other possible causes of constipation, and it is possible that it is simply a coincidence that it developed after this episode of anal sex. The most common cause of constipation is changes in the diet and a relative lack of fiber in the diet. It also can occur from a wide variety of conditions that can cause fluid loss or dehydration, as the colon will try to reabsorb as much water from the stool as possible, causing harder stools. It also is possible to develop constipation from disorders that affect the muscular activity of he gut, either a condition within the gut, such as irritable bowel syndrome, or systemic conditions, such as diabetes or thyroid disease. It is also common for constipation to occur as a side effect to certain medicines.

From the perspective of whether there is an anal problem from the anal sex that is causing the constipation, the first step would be a proper examination by a doctor that is aware that the anal sex occurred, so that it is known to examine for these possible conditions, and possibly obtain a culture. A complete history and physical examination and screening lab work will usually identify if there are any other avenues to pursue. Also, if the blood testing did not include thyroid testing, then it would be appropriate to do so. It is unusual to need to examine the inside of the colon for the evaluation of constipation in a young adult, but it may be necessary in severe or persistent cases. Usually, the approach taken by your Gastroenterologist to provide symptomatic relief, along with increasing dietary fiber and liquid intake and regular exercise, will lead to improvement.

Customer: replied 4 years ago.

Ok, I think I will go and tell the gastroenterologist about the anal sex although it will be quite awkward. Thanks for your information, I have fiber supplements which have 3 grams in each pill and I have been taking one per day. Should I try taking more than one? And I think my stool is often hard do you think I would benefit from an enema?

I'm sorry for the delay, but I had gone to bed when I had not seen a follow-up question for an hour.

It is reasonable to increase the amount of the fiber supplement, but the amount would depend upon the amount of fiber in your diet. The recommended amount of fiber is 20-25 grams per day. If you are eating more fiber (fruits and vegetables, legumes, and whole grains), then it is not as necessary to increase the supplement. But many people have a diet that is high in meats and starches, and increasing the amount of the fiber supplement would be appropriate.

An enema is reasonable to achieve short term relief, but can cause more problems if done too frequently. It will be particularly helpful in people that have a large amount of hard stool that will be difficult to pass, as the Miralax and fiber will do a better job at affecting the consistency of new stool that is being formed.

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