Dear Doc, Do gay men who often engage in anal sex tend to have more colon problems (cancer, etc.) than straight people? Thanks, Larry

Dear Larry, Men who engage in anal sex do not have increased colon problems. The normal mechanical activity of stretching a muscle has been developed to pass stools that can exceed the diameter of an erect penis.

There are caveats however. There can be pain if people have anal fissures. Also, the anus passes vast amounts of bacteria which compose 1/3 of the volume of stool. And, the soft tissues are sensitive to trauma and the micro-hemorrhages that occur with intercourse are channels to infect the body with the viruses of HIV and Hepatitis as well as bacteria such as salmonella. With all the bacteria it is remarkable how our immune system protects us.

It is good to relax muscles of the rectum and take it easy at the early stages and always use protection. However when i did a fellowship in Africa during medical school, a four finger dilating anal stretch was used to treat hemorrhoids successfully. -Ellar, M.D.