For individuals who have undergone cancer treatment, particularly those exposed to pelvic radiation or surgery/radiation for rectal or anal cancer, difficulties in bowel control may happen. Some individuals may have even undergone ostomy surgery to facilitate stool drainage. Engaging in a satisfying sexual relationship while managing these issues may create a challenge.

Given the deeply private nature of bowel movements and stool matters in our culture, the presence of an ostomy, occasional bowel leakage, or chronic diarrhea may lead to a complete avoidance of sexual intimacy with a partner. However, having open communication can diminish embarrassment and work up to a mutually gratifying and healthy sex life.

Below are options and suggestions to make sex more comfortable, and to help initiate discussions with your healthcare provider or a wound ostomy nurse (WOC).

Preparing for Intimate Moments: 

• Limit food intake and choose smaller portions before planned sexual encounters. 

• Avoid high-fiber foods that cause gas or odor, such as cabbage, cauliflower, broccoli, beans, and dairy products for those with lactose intolerance. 

• Consider the timing of sexual activity based on your bowel movement patterns. 

• To overcome any fear or concerns around sexual activity, try sexual touching in the shower or tub the first several times — just be careful and don't slip!  

Managing Gas and Odor: 

• Over-the-counter medications like Mylanta Gas® or Phazyme® can help with excessive gas. 

• Consult your Wound Ostomy Nurse (WOC) about over-the-counter diarrhea medications or prescription options for odor prevention. 

• Discuss with your doctor and WOC nurse before trying chemicals like chlorophyllin or bismuth subgallate to reduce stool odor. 

Ostomy Care: 

• Use specially designed deodorizing tablets or pouch systems with filters to minimize odor and gas. 

• If you have a colostomy and haven’t had radiation therapy, seek advice from your WOC nurse on irrigation techniques. 

• Use wide elastic belts, wraps, or pouch covers for additional support and to prevent leakage during sexual activity. 

• Be mindful of sexual positions that may cause discomfort or pressure on the ostomy appliance. 

Ensuring Comfort and Cleanliness: 

• Protect the mattress or sheets with disposable pads for easy cleanup. 

• Keep wipes and a plastic disposal bag handy for quick cleanup. 

• Exercise caution when engaging in sexual touching in the shower or tub (to prevent slipping, as mentioned above) to prevent excessive exposure of the ostomy faceplate to hot water. 

Pelvic Floor Control for Women: 

• Consider consulting a pelvic-certified physical therapist to learn techniques like Kegel exercises for better control of pelvic floor muscles. 

• Biofeedback methods, such as electrical pulses to the anal sphincter, can assist in improving pelvic floor muscle control.