Anal sex after totally colectomy.

If she has an ileorectal anastomosis, where the rectum is retained and the ileum is attached without a pouch formation, you have more flexibility. The point being, that the rectum is quite distendable and why anal intercourse is possible. Most of us have no rectum, and there is a suture line just a centimeter or two from the sphincters. Contraction of the scar can make any anal intrusion extremely painful for many. Plus, the small intestine is not distendable, increasing the risk of perforation.

Bottom line: she needs to know exactly what surgery she had, so she knows her risks. Most of the time the rectum is removed for FAP. Some had what they call a straight pull through, with the small intestine attached directly to the anus without a pouch created. This was especially common in very young pediatric patients a decade or more ago.

If you do decide to pursue it, go very slowly, with lots of lube, and stop if there is pain. Obviously, there is zero risk to avoiding it completely, so that is the best choice.

Jan

she does have the straight pull through without a j pouch. The J pouch is what her father has because the cancer was genetic. she had read of others having successful anal intercourse with the j pouch when taking certain precautions but we can't find anything about the relative dangers when compared to the straight away.


can you give a little more information as far as the differences of a straightaway versus j pouch? is one more safe than the other?

There is actually less space and distendability with the small bowel of a straight pull through than a j-pouch. The BIG issue is whether or not she still has her rectum. If she does, there is less of a problem. If she does not, the same admonitions apply as for the j-pouch. Perhaps even stronger admonitions because of the lack of a reservoir. If she is adamant about wanting to experiment, I would suggest trying a finger or two first and see how it goes.

Jan

So, she kept her rectum?
Pardon I don't know the FAP surgery and implication but I supposed that FAP (cancer) can occur on both the colon (large intestine) AND the rectum so why does them kept her rectum? If she doesn't have a pouch and she isn't incontinent that's probably so, otherwise she couldn't keep much.
If she has her rectum she's right because that's the only part involved in anal sex.

As for j-pouch is another story as it's a new and very delicate organ surgically build, with metal staples attached and can be harmed very easily. So it's certainly NOT advisable anal sex.

I am dubious that she has her rectum, but there was a lot of variety in surgeries 15-20 years ago. A straight ileoanal connection without a j-pouch was more common then, particularly in kids, thinking children could adapt better. Sometimes it worked, sometimes not.

With FAP, I'd think the rectum would need to go, for cancer prevention. But, I would make no assumptions, and it would be easy enough to find out via scope. I trust she has been having regular follow ups?

Jan

yes she has had regular check ups but she honestly has no idea if she has a rectum or not and is to embarrassed to ask her mom. This may sound stupid but is that something she could check herself with a physical exam?

No, but she could certainly ask her doctor. She can also request copies of medical records. She does not have to have a specific reason. She could just say she wants them for her own file. It is not unusual for someone who had surgery as a child to have questions later in life.

Jan

I would not. the chances are to high for damaging the thin layer of colon you have left where they reconnected you. You don't want to mess with something like that.