|Rectal douching (Rectal irrigation)|
Rectal douching (also known as anal douching) is the act of rinsing the rectum with intent to clean it, typically in preparation for anal sex. An instance of this rinsing or a tool used to perform the rinse may be called a rectal douche.
Rectal douching is a hygienic practice to clean the rectum in preparation for anal sex or hydrating the rectum to void hardened stools as opposed to a pharmaceutical method to soften the stool.
Evidence is not clear, but it is possible that rectal douching before anal sex can increase the risk of transferring HIV. There is evidence that douching sometimes can disrupt the epithelium, or tissue in the rectum, and if this tissue is damaged then HIV can spread more easily.
There are reports that activities which can have the side effect of causing unintentional forcing of water into the rectum, such as waterskiing, may cause discomfort but can potentially bring other harms.
Liquid, typically water, is inserted into the rectum by means of some tool. After some time, the water is expelled in the manner of a routine bowel movement, and in the process the rectum eliminates waste and becomes more clean.
Most people who use rectal douching do so with plain water. The use of a hose connected to a tap, either in a shower or sink, has been reported as the most popular way to administer a douche. Another popular way is with a handheld bulb and syringe designed for rectal douching.
Less commonly, some people used commercial products sold for performing rectal douching, with single-use bottles of saline being most used. Also commercially available but even less commonly used for rectal douching are mineral oil products intended to assist in an enema.
Frequency of use
Rectal douching is a common practice among people who take a receptive role in anal sex.
A 2014 study of about 5000 gay males in the United States reported that half of them had used douching at least once and most used tap water. Among study participants, those who were people of color, HIV-positive people, with a sexually transmitted infection, sexually versatile, or who in their lifetime had unprotected sex with more than two partners were more likely to have recently used rectal douching.
One small study of gay males included a survey in which respondents who habitually used rectal douching began doing it regularly around age 25. For all demographics, the average age at which a population might start using rectal douching is older than the average age at which that population started engaging in anal sex.
Society and culture
From a public health perspective, understanding rectal douching practices may be important because the practice can be paired with behaviors which are risk factors to acquiring a sexually transmitted infection.
Research into rectal microbicide to prevent the transmission of HIV increased interest into researching safer and more gentle rectal douching techniques. The hope in that research is that a rectal microbicide could be delivered with a rectal douche.
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