I would say that most of the e-mails I’ve received in response to this blog from guys (and a few straight women!) have been regarding the topic of sex. Most of them are concerned if they could do it or not. I would think that they were asking, because it had been brought up with their sexual partner, and they have obviously been researching whether it can be done. Hence, my blog is one of the first that comes up when you search anything about anal sex related to digestive diseases. I like it that way! For those of you who are complete tops, there’s probably not much information you need from this post anyways, and you can continue your topping ways. But I would advise to read it over, in case you come across anyone who’s living with these diseases, or has had the surgeries, so that you can know and be an understanding partner. And those of you who identify as mostly a bottom, I hope that you will find this post extremely helpful, and as a “manual” to your future, yet altered, sex life.

So here in this post, I’m going to lay it all out on the line about what I know from what we can and can’t do in the bedroom. I will again mention that I am NOT a medical professional, so none of this information should be taken officially, but this is all from what I’ve researched (trust me, I did alot!), and also from what I’ve personally experienced (there’s been a lot of research there, as well!). But then I did hear from someone who said his doctor was so nervous about talking about gay sex, he just told the guy to “use more lube” and ran out of the office! So we have to look somewhere in the middle to find information on such a taboo topic, but I’m not afraid to get it out there, so that there isn’t another person as confused and scared as I was. Some might consider this post graphic, so I advise that if you are not willing to read about anal sex, then please continue on to another post.

Pre-Surgical Passions:

Where should I begin? Let’s start with anatomy. For those of you who are pre-surgery, you still have your large intestine (or some of it anyways), and I’m also assuming you still have your rectum. The rectum is the official organ of anal sex. Therefore, receptive anal sex is possible for you folks. But if any of your were like me, you were so sick and there was so much inflammation it would have been far too painful to even think about having sex. Also, you would be going to the bathroom so many times, the thought of any mess or blood would be enough to kill the mood. I remember also just feeling so down about being sick and I was so weak, I don’t think I ever had the energy to be sexually active. It was a very strange time. But if some of you are stabilized or healthy enough to give it a try, I’d say it could be done. But keep in mind, it is very tender in there, and anal sex will most likely cause bleeding. This will need to be discussed with your partner and you also have to keep in mind that the bleeding is a sign that there is more damage. You really want to take your time and not let things get rough. If there are any ulcers or extra inflammation, then there could be some tearing or damaging that could occur, so please be careful. You must ALWAYS be in control and you should be a good judge of what you can and can’t handle. You’re health is on the line.

Post-Surgical Passions- The J-Pouch:

Ileoanal Anastomosis

For those of you who are post-surgery, it can get a little more complicated. There are a couple options for procedures, but the most common would be the Ileoanal Anastomosis (“J-Pouch”). I will also talk about the ileorectal anastomosis (“IRA”), because that is the procedure I had, and so I’m quite familiar with it. If you have the J-Pouch, the answer to the anal sex question is unfortunately, NO. As can be seen in the picture, the folded small intestine that creates your J-Pouch is sewn right to the anal canal. This provides almost no room for a penis to pass through, as the small intestine is very narrow. I can’t say the exact size, but it’s certainly not much bigger than the width of a drinking straw, or your pinky finger at most. It is also not as elastic as the rectum, so cannot stretch as freely when an object is inserted. There’s also the concern of the suture site being right there, and any stretching can certainly drastically increase the risk of a tear. If it wouldn’t be the visceral skin that is torn, it could possibly be any suture holding the J-Pouch in place, creating the effect of a rupture in the intestinal lining. I don’t think I need to go any further as to how critical that can be. And after what you went through with that surgery, a tear will only land you back on the operating table. I know this is extremely upsetting news, especially if you are younger and get pleasure out of bottoming. But after all the sickness and disease you’ve already gone through, you shouldn’t put yourself at any further risk. Further down this post, I will provide alternative options for sexual pleasure. If some of you are having touble dealing with this information, I advise that you seek someone to talk to, and if you don’t know anyone,  you can always e-mail me (Booties4986@aol.com), and I would be happy to talk with you about it. When I had my first surgery, I thought this was going to be my case and I went through a severe depressive mood, thinking that I was never going to have sex again and that no one would ever want to be with me. Trust me, I’ve been there. I also know what it’s like to think that you’ve lost your “gay identity”, or to feel that the part of what makes you who you are is now taken away. But I always say we have the advances of medicine in our future and perhaps there will be a way someday!

Post-Surgical Passions- The IRA:

Ileorectal Anastomosis

For those of us with the IRA (represent!), we have a slight advantage, but even more care and concern. People with an IRA have all or at least some of their rectum. The rectum is the main organ invovled in anal sex, as it is the only place that the penis goes. It is generally eight to ten inches long, if you have the whole thing. Since I have my entire rectum, I am still able to have sex, but I also use extreme caution. It is similar to being pre-surgery, except there is no pain and disease, but the sex drive is normal. At least it is for me. For one, if you have inflammation of the rectum (proctitis), it happens to be more painful and something you’d want to avoid so that further inflammation or damage doesn’t occur. I came down with mild proctitis recently and it was easily helped with rectal suppositories (mentioned in a previous post). The best way to have intercourse would be to get in the “riding” position. This allows full control to be in your hands. You can let it enter at your own pace, and if it becomes too painful, just get back up. Then you can also control the speed and depth of the thrusting, to make it the most comforatble for you. Also keep in mind that your rectum is now the storage area for all of your bowel movements, since the large intestine is no longer there to do that. They can’t be stored in your small intestine like they previously were in the colon, so you have to be very conscious of what’s going on down there before having sex. Make sure that you have gone to the bathroom and if I can provide a bit of advice that has been extremely useful to me…. douche. I went online and found an anal douche for only about $10, and it works wonders in clearing everything out. Of course it would need to be done right before the sexual act, otherwise time will just bring more bowels into the rectum and you’re back at square one. Another concern for post-IRA people would be the size of you sexual partner. We should always be concerned with girth, but it’s the length that is key here. As I mentioned before, you have a limited amout of space. What once would have passed your rectum and gone into the large intestine, can now no longer fit in the small intestine. It would bring up the same risks as people with the J-Pouch (tearing, bleeding, ruptures, etc), and should be avoided at all costs. Therefore you should cap the length of your sexual partner at 7.5 inches (all us men lie anyways, it shouldn’t be that hard to find!), unless you know the exact measurement of your rectum from your doctor. You should also avoid any sexual position that is out of your control, or where he would be deepest inside.

Heterosexual Anal Sex:

For women, all of the previous information is of course true. The anal anatomy would all be the same depending on what type of surgery you’ve had, but I would say that your rectums would probably be smaller. So something to consider, depending on the size of your partner. Men have prostates, which is what gives us the pleasurable feeling of anal sex, but women however may derive their own form of pleasure from it, or do it to please their sexual partners. I would advise that your partner be aware of your surgical history, and hopefully he will lose his desire for anal sex and stick with vaginal intercourse, to avoid any damage to you. If not, then in my opinion, he’s not a worthy man to keep around. But if anal intercourse is actually something that you get pleasure out of as well, and seek to explore, then read below for the alternatives, as it would be the same for you ladies as well.

How To Prepare:

Anal Douche

If you are pre-surgery, or post-surgery with an IRA, then there is unfortunately almost always going to be a preparation process. It doesn’t look like anal sex is ever going to be this random quickie thing for you again. If you’re at all like me, you’re most likely going to plan your day around whether you think you’re going to have sex or not and might get paranoid about making sure everything is going to go okay. As I mentioned before, the one thing that shot up my confidence was buying an anal douche. I was extremely paranoid because some of the times I was experimenting with sex after my surgeries, I would have a little bit of a mess. Thankfully, I had some understanding partners, but I think there is only so much a person can take. I would eventually just avoid having sex, and on extreme days, I prevented myself eating the whole day, so that by the time I was ready to be intimate at night, there shouldn’t be anything to pass through. Please don’t choose that option, because trust me, stuff passes through whether you eat or not. It’s all part of the body’s natural peristalsis. An anal douche is similar to using an enema, except you don’t have the intense bathroom-usage side effect, and it’s just basically washing your rectum. People who still have their colons might consider an actual enema. I fill mine up with lukewarm water and do two washes to clean things out, right before having sex. The cleaner the water that comes back out, the cleaner you know it is up there. You might even “feel” cleaner and therefore it would increase your confidence, and I’m sure that’s something your partner will notice and enjoy.

Another option is to pay attention to any  medications, supplements, or food you eat that day. I always be sure take the full amount of pills needed, and my last dose of Lomotil right before having sex. That medication slows down some of the working of the intestines, so it can slow down the process of food needing to come out. I use that in the hope of preventing any last-minute digestion while I’m in the bedroom. I also eat a Metamucil fiber cookie about an hour or two before anything, because then things can bulk up and prevent any loose, watery stools that would unfortunately be there no matter what douching does. And of course, eating any bulky food that day will also help and eating it in small amounts, at a decent time before, depending on how fast your digestive process is. For instance,  I feel as though my digestive process is about 5 to 6 hours. So anything I eat in a day, will generally be coming out 5 to 6 hours later. It’s all about timing. I also be sure to avoid anything that doesn’t fully digest. For example, lettuce, raw vegetables, or anything with seeds in it. Since they won’t digest for us anymore, and they can easily get stuck in the tract and not be able to be douched out, they can sometimes appear at the wrong time. This is definitely something you would want to avoid. The last thing you need is to have little bits of broccoli or lettuce involved in your sex!

The last thing that’s smart to take notice of is the environment. If you’re more comfortable in your own place, or have all the previous preparations readily available there, try to veer the act in your own domain. Not only would this increase your confidence, but you would have anything you need close by and are able to use them if required. Also, you can control other aspects of the sexual environment. For instance, if a certain smell is of concern to you, be sure to light scented candles in the bedroom. Not only will this provide romantic lighting, but it will also make the bedroom smell great and hopefully get rid of any concerning odors. There’s also the option of flavored lubricant. The brand, Wet, makes a strawberry kiwi that tastes nice and also gives off a very fruity smell that takes over the room. This is sure to mask any smell, and if he says something about it, just say it’s the only lube you have left. Also, controlling the lighting is another key. If there’s going to be a little mess and you sometimes can’t control it, then it would be better to keep the lights off. No one needs to see any of that, and I’m sure it will increase your confidence. I avoid daytime sex, because I’m just not sure enough how things are going to be and instead of worrying about it, I just keep the lights off, lay a towel down, and enjoy what I can. It should also be noted that having white, or light colored sheets might not be the smartest thing either. I go with the policy of making sure sure I’m as comfortable as can be, and he’s as clueless as can be!

Other Risks & Factors:

As with any sexual act, there are always risk factors involved. And if you couple that with having a chronic disease that may have involved the removal of key body organs, then you have to assume that the risks increase substantially. For those of you living pre-surgery, you most likely have inflammation, ulcers, or sores that are just asking for diseases to attack. It makes you extremely susceptible to contracting an STD, or other types of infection or bacteria that shouldn’t be there. It could easily put both you and your partner at risk. There’s also the risk of further damaging the frail tissue in that area, and from what I remember it was a long struggle just to heal that tissue, and I couldn’t imagine wanting to damage it for one sexual act.

For those of you living post-surgery with the IRA, it’s the same story with the STDs and infections. Most of us will basically always have the inflammation, and if not, then some of you may have scar tissue as well. This all creates a more shrunken environment than is usual. And a smaller environment down there, means it’s tighter and it’s more painful to take, and that pain just leads to slight tearing and bleeding, which can then lead to increased risk of contracting something or causing more scar tissue. It’s an unfortunate cycle.

However, these do not mean that those of you living pre-surgery, or post-surgery with an IRA can’t have sex, it just means that you should be VERY cautious. And it should allow those of you living post-surgery with a J-Pouch feel better about not even having to deal with having sex! It can be more work than it’s worth!

One of the last things I bring up, and it’s definitely a “risk” in my book, is abandonment and rejection. This can happen for ALL of us, whether you are pre- or post-surgery and whether you have a J-Pouch or an IRA. We are different. Just say it to yourself: “I am different”. Different, however, should not be viewed as bad, but just as something other than what society calls “normal”. But being gay, we should all already know the experience of being different and be proud of it! Franky, I think normal is pretty boring. I compare the words “normal”, “common”, and “frequent” with the words “different”, “rare” and “unique”. I’d much rather be the latter. Now that you realize that, you have to realize we are also different within our own community. We are gay men who are living with something that gets in the way of us leading a regular sex life. And because of that, we are more apt to be abandoned by those we love, or rejected by those we hope to love. There are a lot of people out there who don’t understand us and don’t understand what we went through. Some (mostly bottoms) probabaly aren’t going to mind as it might not affect them much. But the tops might not understand why we have to take precautions during sex, and they might lose interest in that. I can speak from personal experience that it’s very hard to get someone to accept your insecurities, your preparations, and sometimes even your scars. I was in the middle of a three year relationship when I got sick, and he was with me through pretty much all of it. I had decided to go through with the surgery, because I knew I wanted to be with him forever anyways, and we had talked it through. So I had the surgery, then he called me and ended our partnership before I even made it back home from my first surgery. Needless to say, I felt naive. But it was a learning experience into the risks of living post-surgery. And each date, or sexual encounter after that has still been a learning experience. I always say to look at it like a “filter”. We are biologically living with something that allows us to “filter out” the unworthy men in our lives, therefore saving much heartache later on.

Alternatives To Anal Sex:

The Bullet

Alas, we come to the topic of alternative ways to get sexual pleasure. The majority of these options work for both pre- and post-surgery patients, so they can be generalized, unless I have specified otherwise. One of the basic options is to just change the type of sex you’re having. If you had mostly, or exclusively, bottomed before getting sick, then consider switching roles. Discuss with your partner whether or not he would be willing to be the bottom from now on. This should also be something that you are willing to do. Some of us may not be comfortable switching roles, or may be bitter about the fact that the opportunity was taken from us, but it’s this or other less thrilling options. And frankly, I’d rather still have sex! If topping and bottoming isn’t how you classify your sex life, and you rely more on domination or submissiveness, then it wouldn’t matter what role you were in. If you were used to being more submissive, therefore leading you to bottom more frequently, then you can learn to be a submissive top. For instance, being thrown onto your back and ridden is just as dominating as being thrown onto your stomach and… well, there’s not exactly a decent word for it, haha. There are always ways to work around sex to make it comfortable for you, and your partner should be willing to do so, as long as he is comfortable as well. I find myself to be a little more submissive, so if I’m going to top, I’m much more comfortable having someone ride me, because then I can still feel like they are in control and like they are on “top”.

If you’re adament about not switching roles, there is a whole array of foreplay to explore. When I was diagnosed and didn’t have sex, my partner and I relied mostly on foreplay. After all, it doesn’t have to ALWAYS be about sex. Making out can become more passionate when it’s not just a time-passer between getting undressed and having sex. We are all (hopefully) equiped with two hands that can come in very handy all over the body. A simple back massage could work it’s way down to hand jobs, fingering (I’ll discuss later), or just an all-over massage that can relax the muscles and increase bloodflow, therefore leading to a more intense orgasm. I personally enjoy oral sex and find it to be satisfying enough for the majority of the time. Just like intercourse, this can involve a series of positions to promote sexual gratification. For gay men, 69 is the perfect equilibrium sexual activity. Both parties get the same satisfaction at the same time, there’s no risk of damaging anyone, and there’s a much smaller chance of transferring STD’s or infections (if done safely). For those of us who have more sexual receptors in the back end, there is of course the option of oral sex back there. This act provides no risk of damage to your surgery site, yet provides an intense stimulation. And from what I’ve experienced, the people that like to do it, REALLY like to do it and won’t mind. Of course, the preparations listed a few sections above should most definitely be taken into account, as you wouldn’t want to give yourself a reputation!

For the second round of foreplay, let’s consider options that involve forms of penetration. Of course these all need to be considered very carefully. One of the most basic forms is, of course, the finger. You should first explore it alone during masturbation. Try inserting one finger (very lubricated) in to get a feel for it and see how comfortable you would be. You should be able to feel the area and get an idea of what you have going on down there, because you’ll want to know when your with someone else. If you don’t notice much discomfort and feel like you can explore a second one, go ahead and try it. I would not advise going beyond two fingers. You might notice, because it will be tighter anyways, and you wouldn’t feel comfortable with anything bigger. Keep in mind, even if your fingers feel okay, it doesn’t mean a penis would. After you get to know it, try it with a partner if they are comfortable doing so. Express that they should start with one finger and keep it slow so you can get adjusted to it. This should provide a pretty safe form of anal stimulation and hopefully keep you from any harm. Other options include sex toys. Please don’t go overboard and keep these to a small size, and simple form. You don’t want anything too big, nor do you want anything with ridges, bumps, spikes, etc. This is a sure way of bringing on damage. At sex stores I’ve been to, I’ve seen really small dildos and other miscellaneous toys meant to be small enough, yet they still provide the stimulation. You may find that many of these toys are meant for use by women, but can easily be used by a man as well.

One of my favorite toys that I always talk about is The Bullet. This can come in many sizes, shapes, and colors, but is generally a small, silver bullet-shaped toy that is attached to a cord and remote. The objective is to insert it into your anus and use the switch on the remote to control the vibrations it makes. They generally range from slow to fast. Please be sure to buy the smallest version of The Bullet you can find and don’t use the high speed unless you’ve used the slow speed often and are comfortable with it. Too many vibrations might increase your chance of damaging something. If it’s too tight and The Bullet doesn’t fit all the way in, keeping it on the opening of the anus, with slight pressure, will still create an amazing feeling. Also, I should mention that if you are topping and you have The Bullet inside yourself, your penis will vibrate slightly. This should create yet another great feeling for both you and your partner!

For those of you who are post-surgery, with an IRA, if you notice some tightness when trying to have sex, there is yet another toy you should try. It’s a Rectal Dilator Kit. It usually comes with three to four buttplugs, in varying sizes. The point is that you start with the smaller one, and work your way up to the larger one, or whereever you feel comfortable stopping. This can help relax the muscles of the rectum and allow you to be more prepared for sex without the discomfort. But be VERY cautious with this, as some of the kits have the largest being so big, it’s alsmost impossible. I would generally stick with the first two sizes and this is ONLY if you have a rectum leftover (The J-Pouchers should not try this). There are plenty of things for you to explore at your local sex shop. Other items include anal beads, finger toys, dildo ice-cube makers, straps, handcuffs, feathers, costumes, poppers, and of course food. I highly recommend you try out these options, as the only thing it can do is make your sex life more interesting, and if you are worried about not being able to bottom, then these will surely pass the time between the sheets!

We have e-mailed each other quite a bit since, and I’m happy to say, I now have a fellow Gay Digesting friend over in Australia! Here is his story:

My name is Joshua, I’m 20 years old and I was born in Brisbane, Australia. I was diagnosed with Crohn’s when I was 11 years old and over the last 9 years I have traveled a rough path to be where I am today. I have learnt a lot about life and myself and come out stronger. I have had plenty of opportunities to recount my story but it is only now that I have the enthusiasm to do so. My story may not be a tragic tale of pain and anguish conveying a great sense of courage and inspiration but it is my story none the less.

November 2002 – April 2004

In November 2002 I saw my local doctor about a painful boil that I had in the unfortunate area of my anus. I was told that with a course of antibiotics it would heal on its own within a couple of weeks. By the time December arrived the boil had only become more painful and swollen, so the doctor prescribed me yet another course of antibiotics for it to heal on its own or it would need to be popped the next time I came in. On Christmas Eve it burst and it seemed that it would all sort itself out. A few months on the abscess had not healed and continued to leak pus. The next visit to the doctor had me referred to the Gastroenterologist at the General Hospital. The doctor explained that I had an anal fistula that would require me to go under a general anesthetic to have a seton stitch thread through the fistula and secured to allow the wound to drain and then heal properly. After several months the stitch was removed under another general anesthetic with the hopes of the abscess finally healing. At this time the doctor noticed that I was suffering from growth failure and along with the anal fistula and family history suspected I may have Crohn’s Disease. The hospital had insufficient equipment to perform a Colonoscopy on me as I was too young and small so I was refereed to the Royal Children’s Hospital in Brisbane. After the Colonoscopy, the results confirmed that I did have the disease and I began taking Azathioprine to control inflammation. Many months on the fistula saw no improvement and it brought me back to the doctor who then advised that I under go a procedure called a Lay-open of fistula-in-ano. Under general anesthetic the fistula was cut open as well as a portion of the sphincter muscle. Over the next month the wound had to be packed daily to ensure that the wound healed from the inside out. The wound took another 2 years to heal completely but at long last the fistula was finally gone.

April 2004 – January 2008

Over the next 4 years I continued seeing the doctor at the hospital every 3 months as I was experiencing stomach pains throughout the day. To help with the discomfort I continued with the Azathioprine and started taking Prednisone. The new medication caused a couple of side effects that resulted in a constant outbreak of severe acne and made my face start retaining fluid and caused it to swell up all the time. Things didn’t change much over the following years and in time I stopped seeing the doctor at the hospital as often and instead went to my local doctor to see how the medication was going. As 2008 began the pains I was having began getting worse especially in the evenings. I was exhausted all throughout the day and I was having terrible lower back pain on the right side. The doctor increased my medication to see if anything improved.

January 2008 – April 2008

I remember the night I had my major flare up very clearly. It was 2 o’clock in the morning when I woke with pains in my stomach. I took some pain killers and went back to sleep. I woke again at 6 o’clock, the pain killers had done nothing and the pain was becoming unbearable. I staggered upstairs to my father and he drove me to the hospital. I spent the next 3 hours in the waiting room curled up on the seat waiting to get in. More urgent patients were being attended to and the doctor surgery was open so my dad made an appointment to see a doctor there. Once we arrived the pain was even worse and I was trying real hard to keep myself together. The doctor said it could be the Crohn’s flaring up or something wrong with my appendix. She referred me to another doctor at the private clinic but that was in another few hours so she prescribed me some real strong pain killers before I went home. As I got to the top of the stairs at home the pain became too much and I collapsed on the floor and my dad had to help me to the couch. I downed the pain killers and waited desperately for them to kick in. While I waited I got the worst of the pain. It’s hard to describe the feeling. It was like being stabbed with a hot knife. At that point I remember banging my fist on the side of the couch and thinking to myself “I want to die.” That had to be the most terrifying experience of my life. Cramps came and went and eventually the pain killers began working and I drifted in and out of sleep. I woke 2 hours later and we drove to the private clinic. There I was told the exact same thing and sent back to the hospital. I spent another 3 hours in the emergency curled up on the seat still in pain in spite of the pain killers. When I finally got in I was pushed in on a wheel chair because it hurt so badly to straighten my legs out and walking had become unbearable. Once in, I was given morphine right away. After the hours of waiting in pain that was such a relief. It was about this time I started losing track of time. I don’t know how long I was in that bed. I had a number of scans done and at some point wheeled into a ward.

Another 4 days I was kept on morphine while the doctors tried working out what could be wrong with me. On my 4^th night in hospital the intense pains came back and my morphine was increased while I had another series of scans during the middle of the night. All I can remember of the following day was a doctor telling me I was very sick and I would be going under anesthetic and there was a chance I would come out of it with an Ileostomy. Before I went to theatre the stoma nurse came and saw me and explained what an Ileostomy was and used a pen to mark on my stomach where the stoma would be formed. While being wheeled away I remember running my hand over my stomach wondering how it would feel with a bag attached to it and how my life would change. Once they were inside they found that the inflammation from my Crohn’s had flared out of control and my large intestine had perforated. So the Ileostomy was definitely necessary.

The next 2 weeks saw me in bed most of the day and night recovering from the infection that I received from the contents of my digestive track leaking into my body cavity. I was in a fair amount of pain and I self medicated with morphine through a pain pump as often as I could. I was visited by the stoma nurse a number of times so she could teach me how to change my pouch and get more supplies to change the pouch once I was home. Gradually I regained my strength and got up for the first time. At first it was a great struggle just to slide out of bed. As well as having the intravenous drip, a catheter and abdominal drain my thighs had swollen up from the medication and they were huge and heavy and I needed a nurse to lift my legs for me at first because they were so heavy and I was so weak. At the end of the 2 weeks I was strong enough to go home and once we got my medication and supplies organized I was discharged.

It took another 2 months to fully recover from the major surgery. My life had been changed profoundly and it took some time to adjust. The first few weeks out of hospital were very stressful. I had a lot of trouble changing my pouches at first and had to change them 3 or 4 times a day because they kept leaking. Once I realized I was stuck in a routine of getting up late everyday, sitting around doing nothing the rest of the day and going to bed with thoughts of low self worth I knew it was time to at least try get on with life. I decided the best way to work my way out of the rut I had gotten myself into was to go back to school and keep my mind busy. I had missed a lot and the school advised me that it might be best to finish the year doing only half my subjects so that my grades wouldn’t fall with the added work load and finish the other half the following year.

April 2008 – January 2010

Life began to regain some of its previous rhythm and for the rest of the year school work provided the distraction I needed. Of course there were a lot of people who wanted to know why I was absent for so long and each time someone asked I made up an excuse that would cover me but in the end I don’t think anyone believed me and they got the feeling that I was uncomfortable discussing it. I don’t know why I didn’t ever tell anyone now. I guess that I thought people would think or act differently around me had I told them or that by not telling people I wouldn’t have to think about it anymore than I had to. There wasn’t a day that I didn’t stress over the pouch that was concealed under my clothing. Whether at school or out with friends I was constantly worrying about when I would have the opportunity to get to a bathroom and empty my pouch before the bag became visible under my clothes or the unfortunate occasion it began to leak. Before I knew it life began revolving around my Ileostomy and everything I ever planned was with the pouch in mind.

Eventually my friends graduated and moved on to university while I stayed behind to finish school. The following year went much like the previous. My self esteem continued to fall and I didn’t even realize just how much I had developed a self loathing for my body. While at school and on the street I would check out guys and feel incredibly inferior because I would never be as attractive and confident as they appeared to be. This was a significant time in my life that was made harder by the events of the last several months. I had only just accepted my sexuality after many years of suppressing it and pushing it deep down inside me where I didn’t have to worry about it. I began embracing my new found self and found all my thoughts about guys and sex where altered by my body and the scars that I now had with me. I didn’t have a clue how sex would ever go down but I knew there had to be some considerations that would need to be taken into mind having a digestive disease and any risks that sex could pose on my health. I would wonder all the time if there were other gay men with digestive diseases and I knew there had to be many others like me but after searching the internet and finding nothing I felt alone in the world. At this point I began to believe that I would never have anyone and be doomed to loneliness for the rest of my life after only just finding this part of myself. The only thing that got me through some of the worst times was knowing that there were people who were in far worse situations. In times of despair I thought about how lucky I truly was and found condolence in my own situation. Most of all I realized how much I took my health for granted.

About half way through the year I had another colonoscopy and the results indicated that the inflammation had cleared up a lot since the major flare up and the surgeon was confident that the risk of another flare up would be minimal and was willing to reverse the Ileostomy. As you can imagine I was all for it and would have said yes then and there but I needed time to think on it. The rest of the year I continued with thoughts about the reversal. If I did decide to go ahead with it I would have to wait until I finished school of course. The only thing I worried about was having the surgery and then there being another flare up soon in the future. I knew in my mind that I would get it done. I had been in a state of constant misery and I saw this reversal as the way out. As school finished and I finally graduated I returned to the doctor and we scheduled the reversal and he went over a few things I could expect from the surgery. He explained that to ensure my intestines healed back together properly they would remove most of what remained of my colon that was still inflamed that might present complications if they did not.

January 2010 – November 2010

As my admission date approached I grew nervous and excited and the day before I photographed my stomach with the pouch both on and off. The following day I was admitted and remember very well the feeling of excitement right before I went under. For 2 years I had this pouch on my stomach and it had made my life so stressful and it would finally be gone. I woke a few hours later and the surgeon said that everything went well and I was back together again. I spent 1 week recovering this time around and just like the last time I was miserable in there but it was a lot easier this time because I wasn’t incredibly ill before the surgery. I was in very little pain and only used the pain pump a few times in the first couple of days. It took awhile for my system to kick in and a few hours after my main meals my stomach had to be pumped through a nasal gastric tube until I began having bowel motions. It took most of the week but my body eventually started working again. I had lost a lot of control of my bowls over the last 2 years and it took about a week to stop having accidents in the middle of the night. Because I had told most of my close friends before the surgery what I had done 2 years previously and explained the reversal I had company during the evenings I was there which made the boredom a lot easier to cope with.

I got home after being discharged and settled in for another week or so recovering at home. Within days I was feeling back to normal and only had mild pain and within the week I was feeling in perfect health. I was happier than I had been in a long time. But within a few weeks I realized that somewhere along the line I got the idea that a reversal was going to solve all my problems. Within a few months life was just as it was for me before the reversal but without the pouch. I don’t know what I thought would change but I quickly realized that the Ileostomy was not as much a burden as I thought it was. There is no doubt in my mind that the reversal has made my life easier and I’m so grateful that I don’t have to stress over all the things that I used to. I’ve been healthy since and only experience the mildest pains once or twice a week and a recent Colonoscopy shows that inflammation is at a minimum.

Almost 12 months on I’ve been enjoying life as much as I possibly can being bag free. I’ve learnt a lot in the last few years, not just about myself, but life as well. I know that my battle with Crohn’s will continue till the day I die and what I’ve been through over the years may happen to me again and maybe even something worse can possibly happen one day. But coming out of this on top has made me stronger. I still struggle with body image and I still maintain the same mind set a lot of the time. I have been left with 4 different scars on my body: a large vertical one that runs down my front, a short but thick horizontal one on the right side of my stomach where the stoma was and a smaller round one above that where I had a stomach drain, and the last being a large missing portion of my anus. I still see them all as ugly, unattractive and a turnoff but they have taken on a new meaning in the last year. They have become symbols of what I’ve been through and a reminder that life can throw anything at you at anytime. 

I try my hardest to change my way of thinking to ensure that I’m heading in the right direction to become comfortable in myself and live my life to the fullest extent. Those who I have told my story to have praised me on the strength I showed and tell me had they been in the same situation they could not have done it themselves. I drew my strength from those closest to me. My father was there by my side every step of the way over the past 9 years and he will never know just how much that helped me through everything. Even my friends, even though they never knew at the time what I was going through they made life worth living even at the worst of times. Writing about my battle with Crohn’s has brought back a lot of the emotions I have experienced over the last 9 years and I know they will always affect me. I can’t change what has happened in my past but I can move on from it taking away a lot of life experience. I know I may well be significantly affected by Crohn’s again one day in the future but I’ll deal with that when and if it does happen and until then I have a lot of living to do.

-Joshua

My latest post was about an increase in stress and how I had thought that possibly it affected some of my issues. Thankfully, none of it has really gotten worse, but it also wasn’t getting any better. I had been so distracted with New York City and getting on with my life, that I think I was ignoring what was happening and just “dealing with it”. And that’s something no one should have to do anyways.

So while I was getting my yearly follow-up sigmoidoscopy, my new doctor noticed a bit of inflammation and said that we should get that taken care of. I believe that would explain my slight increase in urgency to use the bathroom and would also be the problem causing some of my night time incontinence. I had expressed to him that the night time incontinence was something I did not want to deal with and wanted taken care of as soon as possible. I was wondering why I wasn’t waking up to the sensation of needing to use the bathroom, and we just thought it had to do with too much inflammation, and also perhaps I’m getting very tired and have just become a heavy sleeper at night. He didn’t really know the exact cause.

I had kept myself single for 2010, so I could focus on myself and getting healthier and going along with my life. I have recently decided that maybe I am interested in dating again, but now I had this recent bout that was holding me back. My concern was that I would meet a nice guy, then if we did a Saturday excursion or something, I would spend the morning making sure I had all my pills, and that maybe I would take an extra fiber supplement, so it didn’t look like I was going to the bathroom alot. I would also never bring up anything about being sick or having the surgery until a much later time, as I didn’t want any awkwardness.

Some guys have noticied my scar and I just tell them I had an ulcer removed. I neglected to mention the “ulcer” in question was my entire large intestine. Another major concern for me, that causes lots of stress is what to do if they want to spend the night. The sexual part doesn’t bother me as much, because I always prepare for that and have gotten more comfortable. But with my new issue of some night time incontinence, I’m paranoid about letting someone spend the night and possibly me having an accident. Also, I get up to use the bathroom about twice a night, so I know that would be something they notice as well. So when it comes to that, I’m always awkward and usually avoid having someone spend the night. This is SURELY something that will avoid allowing me to enter a relationship.

So after the scope (which my doctor found nothing else concerning besides the inflammation, thankfully), he prescribed me rectal suppositories. I had been on these right after having my second surgery to take care of some inflammation. I eventually stopped after a refill, because I was seeing someone at the time and it wasn’t convenient for me to remember to use them at night and I also felt that I didn’t notice much difference. But it was right after my surgery and I was on such a kick about feeling good, I don’t think I paid much attention, or I just attributed any issues to the healing process.

He prescribed me Canasa, which is a non-steriodal anti-inflammatory drug (NSAID), similar to aspirin. The suppository I was on before was a hydrocortisone and he said because of my previous history of dysplasia that he wasn’t comfortable prescribing anything with a steroid in it, because he didn’t want that to feed any growth. I had never thought of that, but was glad that he did.

It took about two weeks, but all of a sudden I noticed a definite difference. My first time going to the bathroom all day wouldn’t happen until about 3:00pm! It’s prescribed to take at night, but I was worried with my going to the bathroom at night that it would just come right out and not be very effective. So I use one in the morning, right before I go to to work. That way it can stay in longer and has much better success for me. After a scope one month later, he noticied a significant decrease in inflammation. Excellent news!

Due to the success, he told me it would be okay to start taking them twice a day, one in the morning and now one at night. This is in the hopes of trying to clear up the night time incontinence. My night time issues got better as well, but I’m looking for them to be completely gone, and it was still sometimes unpredictable. I see him again in about another month and hope for further reductions in inflammation and eventually being able to go a whole week without any night time issues!

Sorry I know it’s been quite a while since I’ve posted on here. Life has been pretty busy to say the least, plus I haven’t had many updates to post.

To start off, I want to mention the CFFA charity walk I did. It was May 1st here in Albany and I decided to host a brunch the morning of for my friends and for those walking with me. I had friend in and out all morning, and wayyyyy more food than was necessary, but it was good time and the mimosas were great! Only three of us went to the walk, but I went there $1,200.00 that I raised individually! It far exceeded what I raised last year and I felt very successful in helping out this cause. I was also proud to be walking with my peers who have suffered along with me. I find the TakeSteps walk to always be an emotional experience.

Also, I move to New York City this Saturday (July 10th)! It’s been something I’ve been planning since New Year’s Day 2010, which was the day I told myself I would have a new life. My planned date to move there was October 10, 2010, but I put an application in at Mount Sinai and got a call back for an interview in about two weeks! The interview went great and three weeks later I got offered a position as manager of clinic at Mount Sinai.

I love my current job in Albany and felt really bad about leaving, but there’s nothing going on for me here in Albany and I can’t miss out on this great opportunity. But needless to say, the past month of my life has been very hectic and stressful. First there was waiting to hear back about the job, then the non-ending search for an apartment, and now I’m at the point of trying to sublet my current apartment and pack up my whole life for a big move to Manhatten.

I think these events have flared a little bit of a stress-related bowel issue with me. It’s nothing bad and I don’t feel there’s a serious problem, but I’ve noticed a go to the bathroom a little more frequently the past couple weeks, and I think I may also have a hemorrhoid or some swelling. There’s no bleeding and there’s no pain, but I’ve noticed some increased incontinence. That’s the most annoying part for me and makes it hard to get a restful night’s sleep. Especially at this time when I need to rest my mind the most.

I just started taking my lomotil again last week and also started my steroid suppositories. These are prescriptions I’ve had around, but that I stopped taking because I didn’t feel I needed them. I’ve noticed a little bit of improvement, but I also didn’t change my diet. That is something I’m going to start doing this week, and hopefully in another week or two can be over this little flareup.

I’ve always been a firm believer in mind over matter, so that’s why I think I just have to get my mind on the right track and get over the stress and that my body will follow suit.

Does anyone else normally live healthy, but experiece little flareups related to stress? And what do you find helps the most?

I also walked last year and it was a great experience that my parents came up for, and some friends from work also joined me. It felt amazing to have people that cared about me take a day off work to participate in a charity event I cared deeply about. We ended up raising just over $600.00

There were also free T-shirts, bandanas, and hats that you get when you participate. Hopefully some of you can join, and if not I’m certainly accepting donations for me team!

Site Link: http://online.ccfa.org/site/PageServer?pagename=TS_homepage

Link To My Page: http://online.ccfa.org/site/TR/Walk/Chapter-UpstateNY?px=1443825&pg=personal&fr_id=1802

In my response, I asked her what type of surgery he had, how long ago, and to clarify the reddish color. These can all be important in determining where the color might be coming from, and whether or not it’s normal.

From what I’ve previously looked into, it seems that darker reddish or black stools can indicate a problem in the upper part of the digestive tract, while brighter reddish stools can indicate a problem in the lower part. It could be as simple as something like an anal fissure or hemorrhoids, but it could also be more serious signs of something like colon cancer, or a digestive disease.

Seeing as we all have lived with a digestive disease, how can we differentiate what’s normal to be in a stool? First off, I need to say that you should ALWAYS ask your doctor first and take his/her advice. There is too much information on the internet and some of it might be false, or lead you into thinking the wrong thing, therefore causing some much unwanted stress. I can’t even assure that this information is correct, this is just what I’ve seen many times before from different resources.

I know I’ve seen a vast amount of colors in my own bowel movements, and I can usually always attribute it to something I’ve eaten. Since we are missing our large intestines, our food obviously isn’t totally digested by the time we excrete it. This would mean that any food with certain colors can also come out those similar colors. I know red gatorade, beets, Kool-Aid, or tomato juice can all cause a red color. When I take a multi-vitamin with iron, I notice my stool is is a lot darker than normal, and I know it’s because of the iron.

People like me, who have an ileo-rectal anastomosis, still have their rectum intact. There are chances that one could still get minor colitis in the rectum, and this could be a source of a reddish stool if that’s the case. For those living with the J-pouch, a reddish stool might be a sign of pouchitis, an infection that can be cured by a treatment of antibiotics. For anyone else, you might want to consult your doctor so you can get an answer as to what might cause the coloration.

As for us gay men, if you partake in receptive anal sex, it could be damage from sexual contact. For those living with the J-pouch, anal sex is not recommended at all, and I can imagine it would definitely lead to some bleeding. This is a very tender area and something you would definitely want to take care of.

Does anyone else see similar colors? And if so, what have you heard about the causes of this?

In the past decade, I had a total of 7 surgeries, including the colectomy, facial reconstruction for an underbite, tonsils, removal of dysplasia cells, and removal of my wisdom teeth. I also dealt with coming out to family and friends, achieving a college degree, attempting a long-term relationship, and finally getting a full-time job. Not to mention the whole ulcerative colitis and major surgeries combination, just to end out the decade.

Of course, I don’t find this to be any more intense than anyone else’s life, I’m just ready to close out the chapter of the 2000′s and start a new one with the 2010′s. I rang in the New Year just the way I wanted my new life to begin: I went out alone, and I went home alone. I couldn’t really get any friends to commit to going out, and I didn’t want to hang at someone’s apartment, I wanted to go dancing and have a good time. I normally would NEVER go out alone, because I usually would just feel like some weirdo in a corner, but I had decided that it would be a self-exploration exercise.

I walked into the club with confidence and ordered a drink at the bar. There were couples everywhere, so I went upstairs to the dancefloor. I stayed up there most of the night, making eye contact with one guy that had been staring me down for a little while. This made me smile, and no matter how you feel about yourself, it’s always good to know you still got it! As the countdown began, I briefly worried that I wouldn’t have anyone to kiss at midnight, then realized that I didn’t NEED anyone to kiss at midnight. If I had myself, I had enough. When the clock struck midnight, there were cheers and screams and I apparently was standing under a confetti bucket, because about a pound of confetti fell on me, in my drink, and in my champagne toast. It sucked, but was kind of funny, haha. This opened up the window for that guy to approach me, because he came over laughing and helped me brush off the confetti, to which we discussed the joys of being out on New Year’s Eve.

We chatted for a little bit, and danced for a little bit, but he wasn’t totally my type. Normally, I would ignore it and still want to hang out with him, and I would secretly never be happy about it and it would eventually cause us to have an argument about two months down the line when we can’t figure out why things aren’t working out. So I had taken lessons from the past and decided to not make the same mistakes again. I hung around the bar again for a little bit and some guy came up to me and said that I was “the most gorgeous person of the new decade”. Haha, this really got me going and I thanked him and decided that now was a good time to leave the bar, because I was feeling great about myself and great about the new year.

I went home that night and layed in bed, thinking about my New Year’s resolutions:

• I want to not think about diseases or surgeries for a whole year
• I want to find friends that I can call last minute and they will genuinely want to hang out with me, and will be free to do so
• I want to volunteer some time to help others out
• I want that toned, fit body I’ve been trying to achieve since high school
• I want to laugh more often
• I want to focus on myself as an independent person and try to realize that I don’t need a relationship to make myself complete

What are your resolutions for the New Year?

P.S.- I was also thinking: If anyone has an ostomy, I think going to New York City for New Year’s Eve would be a good idea. If you think about it, those people that crowd around Times Square can’t lose their spot to go to the bathroom. And you hear about people who say they wear adult diapers and just go right there. So if you have an ostomy, you wouldn’t need to go to the bathroom, and therefore wouldn’t have to worry about losing your spot in Time Square. Take advantage of the benefits of having an ostomy! =)

Let me know what you guys think!

6 months post-op

I remember when I had first heard about the procedure, all I could think about was what my stomach would look like with a scar going down my entire torso. It was terrifying and as a gay man who was 22 years old, I had thought that it would ruin my idea of a beach body. I would never have the smooth, chiseled so greatly desired and admired by other gay men. I would never be able to let someone rub my stomach, without thinking they were wondering what the heck that thing was.

1 year post-op