Ask the Doc :: Cleaning Out
Dear Dr. Jason,
When I have sex, I like to douche/enema before. What are the risks involved with this? Oh by the way I'm a bottom.
Doctor Jason's Response:
It is wise (and generous) of you to have a clean environment before anal activity, but how you go about doing it is important. Certain commercially-available enemas can be quite caustic, especially if used frequently. Repeated use of a chemically-based enema can cause irritation and inflammation of the rectal mucosa, thereby potentially increasing your risk of acquiring sexually-transmitted infections, including HIV. Using a warm water or saline enema would be more ideal than a chemical solution, if being used on a routine basis.
If you are HIV-infected, or have any other immunocompromised health condition, then repeated enemas are not recommended as they can increase your risk of developing infections. Whatever you do use for the enema--a plastic enema bottle, a shower nozzle attachment, garden hose--it should be used only by you and thoroughly cleaned after each use if it will be used again. This will decrease the risk of infection.
Dr. Faulhaber is a graduate of Tulane University in Psychology and Cellular and Molecular Biology and received his medical degree from the University of Medicine and Dentistry of New Jersey, Robert Wood Johnson Medical School. He performed his residency training in Internal Medicine and Pediatrics at Saint Vincent’s Hospital in Manhattan, where he then served as a Chief Resident in Internal Medicine. He completed his fellowship in Infectious Diseases at New York University, where he specialized in HIV/AIDS, Hepatitis, and fungal infections. Since fellowship, he has been working as an Internal Medicine/Infectious Diseases physician at Fenway Community Health in Boston. He is a Clinical Instructor in Medicine at Harvard Medical School, and he is affiliated with Beth Israel Deaconess Medical Center. He has been the lead author or co-author of several journal articles and textbook chapters on infections with HIV, other viruses, bacteria, and fungi. He is also accredited by the American Academy of HIV Medicine.
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