This article was published on January 18th, 2018

Haven’t we all taken a little more than we could chew?  Or maybe you are the motherfucker with that big, thick dick that broke someone else’s ass? Regardless of whatever the scenario, cuts or tears in the ass, called anal fissures, not only hurt like a motherfucker, but if managed incorrectly from the onset, could lead to detrimental effects—all limiting positive anal engagement. Let’s put it another way—having a torn ass removes you from that fun and amazing bottom train we all love so much. Let’s dive real deep into fissures with the mindset: how do we know when something doesn’t feel right?

The typical client that comes through the Bespoke Surgical offices either hasn’t prepared for anal engagement with prior dilation, doesn’t use enough lubrication, or simply accepts a little more than the anal skin can handle. Once maximum capacity is reached, or the force is too great, a tear ensues. Most of the time, the tears are either towards the tailbone or in the testicular region at the anal rim, simply because the skin in this region is the most delicate. Now that we think there’s a tear, what symptoms should I be paying attention to? Hold onto your hole. Don’t worry, here’s what you need to know:

Symptoms

The most common post-fissure symptoms consist of pain, both during and after defecation and/or if one attempts anal intercourse (some may not see this as obvious, but bottoming is only going to make it worse!). Bright red bleeding can be seen either in the bowl or streaking the sides of your excrement. A swollen, irritated, and spasmodic hole can really limit your quality of life, not just in the bedroom. All of this for the most part starts from defecation and can last a few hours after a visit to the bathroom. But what to do? Keep reading.

Early treatment

The simplest recommendation: take a break and cease bottoming. I could never fully understand how it could feel sexy taking it up the ass with a rip, but I see it all the time. Next, drink plenty of liquids and please use stool softeners, like Docusate or regular fiber supplements (though sometimes fiber bulks the stool too much and creates huge logs, so be careful how much you take), all to assist in softening the stool.

Epsom salt baths, non-steroidal’s (like Ibuprofen or Motrin), suppositories (like Calmol-4 or Preparation H), and a prescription for both muscular relaxers and numbing creams (Cardizem or Nifedipine with lidocaine) are imperative to assist acute fissures in healing. It can take a week or two to finally heal and one can certainly have some periodic setbacks during this process, so don’t get discouraged.

If it seems all has healed, and you’ve been using the bathroom without issues for some time, then try using a small butt plug first before the big D. Slowly dilate and see how it fares. If it’s holding up, then choose wisely on the first cock you sit on and stay in control through to climax. If the fissure just doesn’t seem to heal with conservative medical management, surgical evaluation is the next step. Don’t fret—the pain from surgery isn’t much different than what you have been suffering with already.

Surgical evaluation and management 

OK – so you’ve tried everything, and it just continues to tear. This is more common than you think and the scar that forms on the fissure line just isn’t strong enough to withstand the pressures of defecating, let alone the force of fucking. So, it makes sense that this tissue needs to be cut out (called a fissurectomy), cleaned out, and encouraged to heal with a stronger scar.

Another key surgical component is using Botox in the muscle and skin lines which allows not only relaxation to heal in the immediate post-operative period, but also assists in post-dilating encouragement of scar formation in the region. This is essential for appropriate healing, as well as the rough and tough tensile strength we all need—all in the name of bottoming like a pro.

This process does take time to get us back on that horse—roughly 2-3 months. The initial healing takes 1-2 days (while on pain medication) and then 1-2 weeks with issues during trips to the bathroom, though again, nothing worse than you’ve already experienced.

Finishing up

The complete process of fixing and recovering from anal fissures for sure sucks the big one (and not in a good way). The key is to understand the mechanism of injury and truly work on risk reduction so that you never get one in the first place. Yet within the bottoming world, it is truly inevitable, so don’t think your asshole is alone here.

Now that you know what an anal fissure is, what the symptoms are, and how to treat both acute and chronic tears, the next step is how to prevent them. No, the answer is not to avoid bottoming. Who the fuck would ever want that? The best bottoms either consistently bottom (doctor’s orders) or use dilators to assist stretching for acceptance and toughening the external entry point in between bottoming.

Also, never forget – lots of lube, boys.  You can never have too much, and silicone works the best for anal engagement. In addition, proper positioning for entry is key and continued control even if it becomes more aggressive as you get going.

And lastly, choose the right size for the right pelvis. If you are a petite bottom, huge dicks sometimes simply can’t and shouldn’t be allowed to enter. Or if they do, just make sure it’s worth it. Sometimes they are, aren’t they?