It’s late at night or the weekend, and you’ve found yourself needing some answers. Unfortunately, it’s outside of regular business hours; so, our offices are closed. If it’s a medical emergency, please dial 911. However, if you have a common question about your experience with anal play (dilators, toys, or the big D) or you’re a patient looking for help with your post-surgical care, keep reading.

You may be experiencing things like pain, bleeding, or some other issue that has presented itself during or after using toys or having sex, or even after going #2. First, we are sorry. No one wants to be dealing with any of this (no matter what day or time it is). Just remember: don’t freak out! Your gut might tell you to immediately run to my office or to reach out to me in a panic. This is why I wrote this guide: to calm your worries and provide you with a plan for the next few days. Because what you’re about to read is exactly what I would tell you to do if you called, texted, emailed, or visited me in person. Let’s dive in.

Epsom Salt Baths

Epsom salt baths are great. They provide two major benefits: (1) they chill you out and (2) they help increase the local blood flow, which soothes the anal region. I recommend taking at least two a day (more if you’d like). And make sure your ass is fully submerged in the water and your cheeks are open to maximize contact with the Epsom salts.

Stool Softeners and Laxatives

Do your best to try and keep your stool soft and your bowel movements easy. I would add over-the-counter stool softeners, like Colace, three times a day. Make sure you drink tons of water and, if you’re constipated, add Miralax (another over-the-counter option). Just a capful of Miralax at night with water or juice goes a long way. Keep this up for a week to 10 days, until things are improving, and then you can titrate back down to simply focusing on natural fiber and your regular diet.

Preparation H Cream

The most common hemorrhoid remedy is PrepH, and it can be found at any pharmacy without a prescription. They make many variations and each of them will do the trick. Some have lidocaine as a numbing agent and if you’re in pain, this can be a great addition. We will speak of suppositories later on, but I would apply the PrepH cream both on the outer rim, as well as just inside your hole. You should apply this at night before bed and after each bowel movement. If you prefer using the applicator that comes with it, you’ll want to lube up the supplied tip before delicately (and slowly) inserting it into your rectum. It should go in easily. Once you reach the end of the applicator (where it’s attached to the tube), stop, and then gently squeeze a small amount until you feel a wet or cool sensation in the area. Remove the tip, properly clean it according to the instructions on the box, and then go about your day.

Calmol-4 Suppositories

Calmol-4 suppositories are life changing. They contain cocoa butter and do a fantastic job at soothing the inside and exterior of the rectum. These can also be found over-the-counter, but aren’t as widely available as the other products I’ve recommended so far. I more commonly see them at mom-and-pop pharmacies and on Amazon. If you can’t find them, the PrepH suppositories will suffice until the Calmol-4 ones arrive. I recommend using these at night, before bed and post-poop. Leave them in a cool area (even the fridge) as they can easily melt, especially in warmer months or climates. If you recall above, I told you to apply the PrepH cream first. There’s a reason for that: to pre-lubricate the area, which makes inserting the suppositories really easy. If during the first few days it’s too painful and there’s no way anything is getting up in there, don’t fret. Just do all the other steps, and each day you can try to see if you can handle inserting the suppositories. You’ll notice almost immediately that they really help coat the anal lining, allowing bowel movements to be that much more comfortable. Suppositories are like little bullets of goodness. They come in individual peel packs. Peel out the suppository and gently insert into your booty. You will need to place a little bit of pressure to get them past the last internal anal muscle (4-7cm) and finally pop into the rectum. Read the box instructions carefully, especially if it’s your first time using suppositories.


I would get 4×4 surgical gauze to place in between your buttcheeks. Roll it like a cigarette and place it right up against the hole. It will catch any bleeding or mucus, and also keep the lotions and such in place. Also it won’t soil your expensive underwear and sheets. Trust me!


Staying hydrated is essential. So, make sure you’re drinking plenty of liquids throughout the day. I think going back to your normal diet allows your body to get back to its known habits. But many people may opt for blander, softer foods, as if we had the flu or an upset stomach. I will leave that to you. But don’t overdo fibrous foods or fiber supplements, if you’re suffering from constipation. Remember: fiber bulks your stool and if you have too much fiber, you can actually make it harder to poop.

Anal Dilators

This section is for my anal dilator crew, whether you’re doing your post-surgical exercises, learning how to bottom, or maintaining your existing practice. When you go from one size to the next, it’s super common to experience some irritation and/or minor bleeding. We are creating microtears or the scar is being stressed and stretched during dilation exercises. This is totally normal and I would initiate these protocols to get us back on the right track. It takes time to get to where we want sexually and this can be frustrating. But re-read our dilating protocols and taking some time off in between to let things heal will be beneficial in the long run..


Let’s recap. Bleeding, pain, and discharge is normal. This can happen for 5-7 days. The good news is, if the above management is working, we will notice things improving. Because we shit daily, it’s normal for the healing process to take time. It’ll be easy, but don’t get frustrated. Stay the course. While you’re healing, I would try to think about how this happened in the first place. Was it a shitting issue? Did you notice it during dilator or toy work, or during sex? Could it be an STD? If so, please make sure you get full evaluation done with bloodwork, swabs (anal and oral), and a urine check.

Maybe shit just happened and now it’s turned into a discussion point to try to not have this happen again. If so and it warrants an office visit, we can make an appointment to chat further on this. Speaking of appointments, we are more than happy to see you if your symptoms are persisting, even after the above has been initiated, or you just need peace of mind to feel like your regular self again. But if in a week to ten days you feel much better and these symptoms are abating, you can wean yourself off the above management and see how it goes over the next 3-5 days. If your condition is still improving and you want to get back into anal play, I suggest starting with the two smallest dilators in your set and, of course, lots of lube. Use these dilators or your toys to determine whether or not everything is healed. They should enter with ease, without any of the previous issues. If you succeed, then you can gradually progress back to anal sex (if that’s what you want).

However, if you’re still not feeling 100%, then you should schedule a time to come and see us. We can tailor your treatment a little more for hemorrhoids versus fissures and/or STD management. Early management is key, hence why I took the time to write this guide. However, on the other hand, seeing me right when it happens isn’t always the answer. Many times, you are in so much pain that I can’t even place a scope into the anal canal to help see what’s going on. When this happens, I will just start you on the protocols mentioned in this guide.

In the end, my goal is to improve your condition. But there is only one of me and many anal issues out there, whether you bottom or not. I am one of the few doctors who gives their clients 24-7 access via email. However, for non-emergencies, this guide is exactly what you need if you experience any symptoms from anal issues. Let’s start here and re-evaluate over the next 5-7 days. From there, if your symptoms aren’t improving, let’s get you in and evaluate potential changes in management. I hope this helps and that you have a speedy recovery.

Have questions during normal business hours? Contact our team.