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Exercises to strengthen and tighten your anal sphincter may help treat bowel incontinence fecal incontinence or reduce your chance of leaking stool or gas in the future. Your anal sphincter is composed of thick bands of muscle.

These muscles that control your bowel can be strengthened through exercise.

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While the internal anal sphincter is not under conscious control, the pelvic floor muscles that form an external band of muscle around the anus are readily strengthened through relatively simple exercises. Sadly, too few people realize that often times simple measures may improve not only their social life and sex life but the quality of life in general. Knowing the muscles that control your anal sphincter and how they work makes understanding the exercises much more clear.

The internal anal sphincter is an involuntary muscle, which means you cannot consciously control it. The internal sphincter is programmed to stay shut, which is why most adults do not leak stool while they sleep.

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However, you can control your external sphincter muscles, which can help you maintain control of your bowels. The organs in your lower pelvis, such as your bladder and colonare supported by a large group of muscles called the pelvic floor muscles.

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In conjunction with your anal sphincter, these muscles help you stop embarrassing gas and stool leaks. These are the muscles that you squeeze tightly when you feel a bout of diarrhea coming on and no restroom is in sight. Likewise, these muscles also help you control urine flow and flatulence gas.

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As we age, bladder incontinence and fecal incontinence can occur due to loss of muscle tone in the pelvic floor. Weakness may occur in younger people as well. It might begin as having less control than usual over passing gas or leaking a little urine or stool with sneezing or standing quickly.

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Yet it can progress to the inability to control your bladder or bowels completely. Other factors leading to fecal incontinence include: ? ?. If you are struggling with leakage of gas or stool, it's important to first talk to your doctor.

New cases should always be carefully evaluated, and this may include tests such as an EMG, ultrasound, and more when appropriate. There are many treatable diagnoses that can lead to fecal incontinence.

In those instances, simply tightening the pelvic floor muscles with exercise would not only be ineffective but may inadvertently lead to a delay in starting necessary treatment. In the absence of any treatable disease or functional problems, you can work to tighten the sphincter and pelvic floor muscles in the privacy of your own home with just a few minutes of exercise daily. The Kegel exercise -consciously tightening your pelvic floor muscles-has been around for decades and is a very simple procedure.

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If you've stopped your urine flow midstream or consciously held in gas then you have already done a Kegel. For women who may have had Kegel exercises recommended after childbirth, it's the same thing. The key to Kegel exercises is knowing which muscles to contract-it's the same muscle group you use to stop your urine flow. You may wish to urinate and start and stop your stream to make sure you know the muscles involved.

Men might feel the muscles differently than women-most men report feeling tightness around the anus whereas many women feel the pull closer to the vagina.

Although you can practice your Kegels standing or lying down, if you're a beginner it may be helpful to try the exercise while seated in a firm chair:. It might help to visualize that these muscles are an elevator and as you contract squeeze them, the elevator slowly rises to the top.

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As you gently release the tension on your muscles imagine the elevator returning to ground level. It's recommended that this exercise is repeated at least 10 times, which equates to two sets of Kegels per day.

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If you're doing the exercise correctly, you should actually feel the pelvic floor muscles lifting. It may be difficult to contract these muscles for a full 10 seconds, but as your muscle tone improves it will become easier. If you repeat the exercise a few times daily, you should have an improvement in just a few months.

Practicing patience is important, just as with trying to strengthen any muscles. If you've ever tried to get in shape more quickly by lifting too much weight or running too many miles, you know that trying to hurry the process along can backfire. Don't overdo it. In this case, more is not better and you can actually fatigue these muscles and cause a little bit of temporary incontinence.

When the weakness of the pelvic floor muscles isn't due to an irreversible injury such as complete spinal cord injuriesa significant number of people improve with the exercises, and for some, the problem goes away completely. If your symptoms persist, there are many options.

If you aren't noticing a change, it's important to make sure you are performing the exercises properly. Your doctor may refer you to a physical therapist to assist you, though it's important to find a therapist who has experience working with people with pelvic floor muscle dysfunction.

A study found that people who underwent supervised pelvic floor muscle training worked with a physical therapist were five times more likely to report improvements in fecal incontinence than those who did the exercises on their own.

For those who don't achieve the result they wish, a study found that using a combination of pelvic floor physical therapy and biofeedback worked better than pelvic floor muscle exercises alone. In addition, adding electrical stimulation sacral nerve stimulation to these two therapies resulted in further improvement.

If you're experiencing leakage of stool or gas or coping with frank anal incontinence, you're not alone.

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The problem is actually very common, and in being so, a significant amount of research has been done on the different ways people can get relief. Anal incontinence or even small leakages of stool or gas can seriously impact the quality of life. If you aren't getting relief with conservative measures there are still plenty of options that may be successful.

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While it's embarrassing at times, speaking to your doctor and exploring the available options can get you closer to living your best life today. Gas pain?

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Stool issues? Nonetheless, STIs do not increase the risk of HIV transmission from people who are taking effective HIV treatment and have an undetectable viral load.

In the PARTNER study, there was not a single HIV transmission even though many study participants had STIs. There are two main reasons for the effect of STIs on HIV transmission. Firstly, many although not all STIs can cause ulcers, sores or lesions. They provide a direct physical route of entry for HIV in an uninfected person.

Secondly, immune cells that are, themselves, prone to HIV infection - such as activated T-cells and dendritic cells - are prone to be present in greater numbers at the site of an infection. The strongest evidence is for herpes simplex virus type 2 HSV Human papillomavirus HPVthe cause of genital warts, is associated with an increased risk of HIV infection in women regardless of whether it is an HPV type that causes genital warts or a type associated with cervical cancer Houlihan.

The presence of HPV in cells in the penis also increases the risk of acquisition in men Rositch. Poppers are nitrite-based inhalants, widely used as a recreational drug by gay men in many countries.

Especially popular for use during receptive anal intercourse, sniffing poppers relaxes the anal sphincter muscles, making intercourse easier and intensifying pleasure.

However, using poppers during uradious.netotected, receptive anal intercourse more than doubles the risk of HIV infection Macdonald. This may be because poppers increase blood flow to the rectal tissues, heightening their susceptibility to infection.

Poppers do not affect the insertive partner's risk of infection.

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Rectal douching is the insertion of a liquid, such as tap water or soapsuds, into the rectum via a tool, to cleanse the rectum before or after anal sex and is a common activity among gay and bisexual men. However, it may damage the rectal lining and remove protective naturally occurring bacteria.

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If the same douching bulb, showerhead or other tool is used by different people, infections could also be transmitted that way. A synthesis of 24 studies showed that rectal douching was associated with an almost threefold increased odds of infection with HIV and a more than twofold increase in the risk of a sexually transmitted infection other than HIV Li.

While it is possible that this result could simply be due to behavioural differences, most of the studies performed multiple analyses to take into account potential confounders such as frequency of sex and partner numbers.

Rectal bleeding also raises the risk of infection, and could be caused by haemorrhoids, certain STIs such as anal warts, herpes lesions, the prior use of sex toys, or by fingering and fisting. There are some data from low and middle-income countries to suggest that circumcision may be protective, but only for men who exclusively take the insertive role Yuan. Rodger AJ et al.

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Risk of HIV transmission through condomless sex in serodifferent gay couples with the HIV-positive partner taking suppressive antiretroviral therapy PARTNER : final results of a multicentre, prospective, observational study. The Lancet You can read more about this study in our news report. Jin F et al. Uradious.netotected anal intercourse, risk reduction behaviours, and subsequent HIV infection in a cohort of homosexual men.

AIDS Zuckerman R A et al. Higher concentrations of HIV RNA in rectal mucosa secretions than in blood and seminal plasma, among men who have sex with men, independent of antiretroviral therapy. J Infect Dis Patel P et al. Estimating per-act HIV transmission risk: a systematic review.

Rectal Tube: insertion, maintenance, and removal

AIDS, Mercer CH et al. Changes in sexual attitudes and lifestyles in Britain through the life course and over time: findings from the National Surveys of Sexual Attitudes and Lifestyles Natsal.

Baggaley R et al. Does per-act HIV-1 transmission risk through anal sex vary by gender?

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An ated systematic review and meta-analysis. American Journal of Reproductive Immunology, e, Hollingsworth TD et al.

HIV-1 Transmission, by Stage of Infection. Journal of Infectious Diseases 5 Looker KJ et al.

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Effect of HSV-2 infection on subsequent HIV acquisition: an ated systematic review and meta-analysis. Lancet Infectious Diseases Laga M Non-ulcerative sexually transmitted diseases as factors for HIV-1 transmission in women: results from a cohort study. AIDS 7 1 Masha S et al. Trichomonas vaginalis and HIV infection acquisition: a systematic review and meta-analysis.

Sexually Transmitted Infections Houlihan C et al. HPV infection and increased risk of HIV acquisition. A systematic review and meta-analysis. Rositch AF et al. Risk of HIV acquisition among circumcised and uncircumcised young men with penile HPV infection. Macdonald N et al. Factors associated with HIV seroconversion in gay men in England at the start of the 21st century.

Li P et al.



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