What Goes Up Must Come Down

X-ray of the pelvis and spinal column
BOOTY ALERT: What Goes Up, Must Come Out….
Date July 13, 2017 Author By bootymd Category health
An Educational Guide
At least once a year, I see a social media post about objects that doctors find inside anuses and the rectum—in addition to what I see in my practice.  Let me just set the record straight—it does happen.  It is not a rare call for a surgeon to get called to the emergency room to remove a foreign object that is stuck up someone’s booty.  Although people who are not in the medical field are often fascinated by what we find or how it got there, my focus is on what happens once the object is there and how to minimize problems in these situations.
Here are some general things to remember:  If a glass object gets stuck up there, it can break when we are trying to remove it.  Don’t insert breakable objects.  If a vegetable or other food gets stuck up there, depending on how long it is there, the heat of the body will start the cooking process and as it gets soft, it can be harder to remove in one piece.  Anything put up there with enough force or far up enough can lead to a hole in your intestine, which then buys you an operation and possible colostomy—so take caution and read the reasons below.

If you insert something that does get stuck up there, remember these tips:  1) don’t wait at home hoping it will come down  2) go to the emergency room  3) be honest—tell the doctor something is stuck up your booty.  If you are embarrassed about it, you can tell the intake nurse whatever you want, but when the doctor sees you, please tell her or him what the real problem is. I know some patients might be uncomfortable about coming to the ER with this problem, but rest assured, your doctor does not care about the circumstances under which the object was stuck up there (unless it was done without your consent).  Our concern is how we are going to help you and get it out safely. Your doctor will likely try to retrieve the object in the emergency room, which is possible some of the time.  If it is not possible, then you may need to be placed under anesthesia to have it removed and possibly need an operation.

Let’s start with anatomy, since this will be key when putting anything up the rear end.  If you spread your butt cheeks and take a look, you see the anal opening that looks like lips puckered in a tight O position because of the sphincter muscle that holds your poop in.  The muscle can have different levels of tightness and you can “flex” it, hence the winking feature that gave it the nickname “stinky winky.”  Once past this muscle, which is not very long, the anus gets wider. That’s why you feel the anus give a little when something is placed past that area, including enemas that are sometimes needed to induce a bowel movement.

Now, imagine watching a camera traveling up someone’s booty.  As you travel upward away from the muscle the anus turns into the rectum and then eventually into the colon.  During this travel, the first portion will be straight and then there will be some twists and turns.  This is because the straight part is surrounded by the fat in the pelvic area holding it in its place and then that fat ends and the intestine is freer in the abdomen. This is very important for reasons you will soon see.

What are the potential problems you can run into when inserting things up your booty? 
That depends on a few things:  the size of the object including the width and the length, the consistency of the object, what the object actually is, how far up it is inserted and with how much force.

Let’s go through the areas that can be damaged starting from the bottom up.  First, the anal muscle can be injured.  This can be in the form of a painful superficial cut called an anal fissure or it can be a deeper damage where the muscle itself is torn.  This is usually due to an object that is wide or inserted with a lot of force, especially when the muscle is not maximally relaxed.  If the damage to the muscle is great, this can be a difficult problem to fix. Permanent incontinence (having accidents to stool or gas), is possible.  So be careful.
The other big problem involves inserting something so long, large or with so much force that it creates a hole in the intestine.  This is a big problem.  If the hole happens to be in the part of the intestine that is surrounded by fat, then there is a better chance that a major abdominal operation is not needed.  However, if the hole is in the part of the intestine that is inside the abdomen, then the person needs an operation to fix it.  This can involve anything from stitching the hole to removing a part of the intestine to getting a colostomy (abdominal bag that collects poop directly from your intestine), depending on the amount of damage.
Just like with anything else we do to our bodies, knowledge is the key to making informed decisions.  Everyone is unique and different things are right for different people.  Once you have the information, you can be confident that you will do what is right for you.
If you choose to put anything past the anal muscle, remember to use a lot of lubrication, relax that muscle as much as possible and go slowly.  Stop if you feel pain.  Preventing damage is better than having to repair it.  Make sure the object is not breakable and is not too hard, too wide or too long.  Finally, do not insert anything with a lot of force.  There are “toys” or products with a flared base or handle especially designed for this purpose which may be less likely to cause a problem (lower chances of going up too high and getting stuck), but same cautions apply.    If you think you may have caused any problems to your booty or your intestine, seek help immediately.  Remember, we as physicians are here to help, not judge; no matter the situation, your health is our #1 concern.

Written by:  Dr. T, BootyMD
July 2017

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