Art & Science

Injuries, Ailments, and Colorectal Surgeries

Fisting After Intestinal Injury

Publication Details

Author: Finn Vortex

Published: 08/29/2016

Updated: 05/24/2017

Duration: 10 Minutes

Quick Links / Topics in this Article

Injuries | Ailments | Colorectal Surgeries | Case Study - Intestinal Tear | Medical Advice

Executive Summary

Examination of potential injuries related to fisting and other ailments and surgeries that can negatively impact the fist chute. Includes an online journal of recovery from injury and summarized advice from fisting pros and medical professionals.

This page has graphic photos of injuries and ailments of the fist chute. If you do not wish to see these images, avoid mousing over any image with the text REVEAL MEDICAL IMAGERY.


As noted in the article Art & Science: Health & Wellness, fisting is inherently dangerous due to the nature of our anatomy. Injury rates increase substantially under three specific circumstances:

  • When either partner lacks the appropriate knowledge, experience and skill for fisting (beware of novice fisting partners)
  • When engaging in extreme fisting (double fisting, full elbow punching, or depth fisting)
  • When controlled substances that affect judgement and awareness are coupled with play (crystal meth is especially dangerous)

Most medical practitioners will advise against fisting in order to prevent malpractice lawsuits. Established fisters (those with 20+ years of experience) are quick to note that most injuries are due to toys or extremely rough play. Intestinal tears, punctures, and anal fissures are the most common types of injuries resulting from fisting and general ass play.

Intestinal Tears and Punctures

Perforations or tears in the large intestine are deadly if untreated. Intestinal bacteria will seep into the gut, resulting in infection and fever.

Perforations or tears in the large intestine are deadly if untreated. Intestinal bacteria will seep into the gut, resulting in infection and fever.


Intestinal tears and punctures are naturally uncommon in the intestine but do happen on occasion when items are inserted into the fist chute. This type of injury is likely due to unmanicured nails, high-powered douches, chains, or toys of small diameter with blunt or sharp edges. Diverticulitis can also increase the risk of tearing.


Initial symptoms may include bleeding, a drop in blood pressure, clamminess, fever, lack of any bowel movement (intestinal paralysis), and mild abdominal pain. Over time, air will begin to escape the colon into your stomach, causing abdominal distress, frequent urination, and shortness of breath. A CT scan will likely identify the air and possibly the location of the tear. Fever will gradually increase, especially if fecal material seeps out into your gut through the tear.

Untreated tears and punctures are lethal within 48 hours of injury and treatment should be sought immediately. Be prepared in advance to discuss with ER triage nurse the nature of your injury. Neglecting to do so may result in your treatment being delayed several hours, an extreme exacerbation of symptoms, a more invasive treatment, and potentially death.


Treatment usually involves a full laparotomy to determine the site of the tear. After the tear has been located, its size will determine further outcomes. Small tears (less than a quarter in diameter) can be sutured up and patched with fatty tissue. Recovery time for patches is at least six weeks to normalcy inside the intestine. Tears larger than a quarter usually involve an ostomy bag and a year-long recovery period (with an additional surgery to reconnect the intestine after healing has occurred). The surgical method of repair for colostomy restoration may affect your future fisting capacity. If possible, you should request that your surgeon use traditional stitches and stitching methods (actual sewing up your injury) instead of the newer O-ring methods. The traditional method heals without creating a lot of scar tissue that prevents future fisting.

Anal Fissures

Fissures can appear inside the anal canal or externally at the opening of the anus. A fissure can look strikingly similar to a syphilis chancre.


Anal fissures can be caused naturally by large and hard stools, constipation, and diarrhea. Rough anal sex, toy play, and improper fisting can also cause fissures. When fisting, copious amounts of the appropriate lube (not KY jelly), warming up/stretching techniques, and gradual insertion can prevent fissures from occurring. Know your limits and follow them.


Pain when defecating and blood in the stool are common symptoms of fissures. Occasionally a rectal itch may occur, especially with micro-fissures. Bowel movements will continue, but may be at a slower pace. Note the difference between tears/perforations and fissures. A tear or perforation will usually trigger natural paralysis of the intestine (you will no longer shit and the desire to eat or drink will vanish).


The nature of the fissure determines the treatment plan. About 80% of fissures will heal on their own if fisting is eliminated for several months, water intake is increased substantially, and a high fiber diet is adopted. The remaining 20% of cases require a sphincterotomy to remove or repair the fissure. Twelve to eighteen weeks of recovery time are suggested to prevent reoccurrence.


A multitude of naturally occurring ailments can affect a fisting Bottom. In fact, almost any GI disease (such as Crohn's, IBS, or GERD) can have an impact on the fist chute and its capacity to gobble up a hand. Four primary and common ailments include warts, hemorrhoids, diverticulitis, and cancer.

Anal Warts

Warts may appear internal or external to the anal canal. If external, a doctor should examine inside the canal for additional occurrences.


HPV is common among most adult gay men, but the strain that causes warts is less common. Warts will appear around the anus and potentially along the tissue of the anal canal. Fisting can spread warts throughout the canal.


Outpatient service or surgery can remove warts (via burning or incision). If the warts were along the anal canal that were removed by incision, six weeks of healing time is desirable. Additional surgeries may be required to remove future warts.


External piles may harden (become thrombosed). Six months is the typical duration for the body to dissolve the clot, often leaving a skin tag.


External piles may develop around the lips of the ass at the opening of the fist chute. Deeper inside the anal canal, internal piles may develop that will either remain hidden or protrude from the anus similar to a prolapse. Depending on the size and type, a fister may experience mild or extreme pain when defecating, getting plowed, or taking a fist. Bleeding may occur.


Diet and ceasing of anal penetration (by cock, toy, or fist) can reduce external and grade 1 and 2 hemorrhoids. Grade 3 and 4 will require a hemorrhoidectomy and retraining of the fist chute. Fisting downtime can sometimes be up to two years.


Tiny pockets form in the large intestine that can fill with fecal material. If a pocket should explode, then infection and fever will follow.


Symptoms include constant pain (typically in the lower left side of the tummy), nausea, fever, constipation, and general tenderness.


Advanced diverticulitis generally means the end of a Bottom's fisting career. Diet can help, but the risk of exacerbating the condition or tearing the intestine is too high to continue fisting.

Cancers & Polyps


There are many different types of cancers affecting the lower GI tract. Colonoscopies are not required (even for FFuck-Bottoms) until age fifty. Generally unexpected weight loss of gain and swollen nodes are the first recognizable symptoms.


Treatment options vary based on the location, type, and stage of cancer. Some cancers may be treated laparoscopically, while others require full laparotomies and ostomies.

Colorectal Surgeries

Treatment for the above mentioned maladies and injuries may require surgery.


Laparotomies involve cutting the abdomen open in order to address an issue with the GI system. Major laparotomies start just below the sternum and proceed to two or three inches below the navel. Healing time is about six months to a year before a patient feels normal.

Keloid scarring is unavoidable, though the size and discoloration can be reduced by using Maderma©, coconut oil, and vitamin E during the healing period. Since the abdominal muscles have been cut, mobility is impaired for about six months and increased fatty tissue can build up which is difficult to eliminate with normal crunch, planks and other abdominal exercises.

Ostomy (Colostomy or Ileostomy)

Colostomy and ileostomies are two types of diversions in the intestine. Ileostomies usually occur prior to the large intestine (and are less common for fisting injuries). Colostomies are in the lower intestine. Both surgeries connect the intestine to an exterior ostomy bag that fills with bio waste.

In some cases, this stoma is permanent; however, fisting injuries do not typically fall into this category. The ostomy is reversed after the intestine heals. At least a year or two of downtime is expected before fisting can resume.


To remove grade 2, 3, and 4 piles, a hemorrhoidectomy is often needed. Depending on the number of hemorrhoids and their severity of grade, fisting may be put on hold for over a year.


Fissures that don't heal naturally may require surgery to reseal the sphincter and anal canal. A six-month downtime is expected.


Since it is impossible to reach the appendix while fisting, downtime is limited to the duration of time a body needs to heal (six to eight weeks).

Case Study: Intestinal Tear


Patient presented in ER complaining of abdominal discomfort after brachioproctic sexual activity. Upon review of sexual practices/history, CT scans, and an exploratory laparotomy, a 20mm laceration in the sigmoid colon, approximately 70mm from the rectum was discovered.

ICD-10: S36.533.

Operative Report


Finn is a pleasant 43-year old gentlemen who presented to the emergency department with complaints of abdominal pain after he and his partner were participating in anal fisting earlier in the morning. The patient states he felt acute pain during the activity in the pelvic region as well as in the left upper quadrant.

A CT scan obtained in the emergency department showed significant amounts of pneumoperitoneum pneumoperitoneum (n)

abnormal presence of air or other gas in the peritoneal cavity, a potential space within the abdominal cavity
concerning for perforation of the hollow viscus hollow viscus (n)

any orgarn that is hollow on the inside, such as large intestine, small intestine, stomach, or esophagus
. Therefore, it was determined that the patient would require an exploratory laparotomy.

All risks/benefits explained. He indicated understanding and consent form signed.


After appropriate consent was obtained, the patient was taken to the operating room where he was placed supine supine (a)

laying on the back, face or front forward
on the operating table. General endotracheal endotracheal (a)

placed or passing within the trachea/throat
anesthesia was achieved without difficulty. Bilateral lower extremitybilateral lower extremity (n)

compression devices were placed and appropriate perioperative perioperative (a)

occurring during a surgical operation
antibiotics were administered. The patient's abdomen was prepped and draped in the usual sterile fashion and a timeout was performed.

Journal / Blog

08 August 2016

My regular fisting buddy came over for our weekly fisting today, but things didn't turn out as desired! This was supposed to be a week of intense fisting and training to reach elbow-depths on long arms and near pit depth on short arms.

Blunt, non-flexible, hard points from these makeshift lube injectors are the most likely culprit for the sigmoid puncture.

We began our normal fisting routine with one exception: after his hand was past the sigmoid curve, we injected additional lube with a makeshift injector. We then resumed forward progression and within 90 seconds, he was two inches from the elbow—our traditional block! I took a hit of poppers, and we continued on until he was nearly through the last ring. Upon extraction, something didn't feel right so I excused myself to the bathroom. After several minutes, I was unable to expel the additional 150 - 200 ml (3/4 cup) of lube we had injected with the exception of about 10 ml. That expulsion had a dark red drop of blood.

As I began to feel clammy, I lay down on the floor of the bathroom and call the session to an end. My partner began cleanup and after a few minutes, I joined him in the walk-in shower, only to have to lie down again. Three minutes later, I had my partner call 911.

After the EMTs arrived, they determined my blood pressure was extremely low (90/50) and my oxygen saturation was also low (80% saturation). They helped me dress and provided oxygen. After several minutes my BP and oxygen returned to normal levels, so I sent them back to the station and lay down for a nap.

After four hours of napping, my temperature had risen to 100.1 degrees. After another hour, the temperature had risen to 100.3 so my fisting partner brought me to the ER. I followed the script previously prepared for such emergencies. After five hours and a couple of CT scans that determined my bowels were full of air (a sign of perforation), I went into surgery.

09 August 2016

The surgery wrapped up at about 1:00 AM with most of the time spent navigating through scar tissue from the previous laparotomy, appendectomy, and cholecystectomy (gallbladder removal). I'll have to keep oxygen tubes, nasogastric tube, and catheter for at least twenty-four hours. My scar goes from the sternum to below the navel and has about seventeen staples. The nursing staff come and poke me every couple of hours, but thanks to the Morphine and Dilaudid, I am able to sleep.

10 August 2016

They removed the oxygen and catheter today! It makes it easier to walk, but it's hard as hell to sit up, and my back is tired from lying in bed. I might get to eat tomorrow (ice chips are getting old)!

11 August 2016

The NG tube came out today. I'm getting tired of being woke up every two to four hours. Visitors are now coming daily. We play games and talk. Then I take morphine. No food yet, but they have approved gum and jolly ranchers.

12 August 2016

Clear Liquids! Popsicles, broth, juice, morphine! The goal is to walk every day, sit up as long as possible, and pass gas!

13 August 2016

More clear liquids. I've got a thousand doctors (mostly med students) that check on me every day.

14 August 2016

Liquid diet starts today with ice cream, cream soups and Jello. I finally passed gas!

15 August 2016

Solid foods for breakfast and discharge. It was seven days in the hospital from admission to discharge. The laparotomy has actually decreased my original scar. I've lost 15 pounds, and I'm very bloated. The next phase just includes monitoring bowel movements, increasing daily activity, and resting.

16 August 2016

Sleeping is most of my day and night. Neighbors are starting to show up to visit, but I'm not really in the mood.

18 August 2016

Went to see my regular doctor today. We dropped the Truvada for a while, and got some additional painkillers (Tylenol 3 with Codeine). He advised against any fisting in general because of the danger involved (regardless of surgeries or not). He also mentioned there was some biopsy reports that are not in the discharge papers. He suggested I visit a gastroenterologist. I immediately booked an appointment for Monday.

22 August 2016

Visited gastroenterologist today. I had an incident at the doctor's office prior to the appointment where I started getting clammy and lightheaded. BP and oxygen was good and bowel sounds are normal. I took a suppository because it was two days without a BM. He advised against depth fisting and only shallow rectal penetration.

25 August 2016

Visited the general surgeon today. He removed the 17 staples and listened to the stomach. Everything is going as planned. He says that the strength of the intestine should return to normal strength after six weeks. Previous biopsy of tissue returned normal results.

27 August 2016

My complaints and issues now deal with constipation, posture, and pain in the kidneys. I've lost all desire to eat, though I can walk around the block and I did make it to the grocery store on my own yesterday.

01 September 2016

I'm now able to walk about two miles per day, but there is still abdominal pain when sneezing and when riding on bumpy roads.

15 September 2016

Minor abdominal pain still exists; however, I'm able to sleep on my side without having residual pain for the remainder of the day.

17 September 2016

Took my first fist in the rectum (below injury site) and toys up to the sigmoid. No issues seen or reported.

17 October 2016

Taken several fists and begun rectum and canal stretching for medium hand double wide. Some pain felt after. Also spoke with acquaintance that knows great details about how patches are fixed in the GI tract and how long to wait. He said the silk stitches will take a year to dissolve and the prolene stitches are permanent.

7 November 2016

Pelvic surgeon fisted me today and said he can feel the patched area just past the sigmoid. He advises another six to nine months before depth fisting.

03 February 2017

Fisted guy who had colostomy due to toy play accident. He says he waited two years before fisting and another year before fisting past injury.

12 February 2017

Took SquarePeg Slink XL past tear today. Minor pain followed.

13 March 2016

Took Holmes and Hung/BAM past tear today. Minor pain followed.

05 April 2017

Took Mr. Hankey's Stump and Dump two inches from the base. Sloughing of intestinal lining visible. Pink.

12 April 2017

Took ffriend's hand past the second ring. Pinkness and sloughing occurred during session.

06 May 2017

Small build top (5'3" / Small Hands) fisted me to his elbow today. Pink.

14 June 2017

Medium build top (5'11" / Medium Hands) fisted me to his elbow today. Pink on third full insertion.

Medical Advice

Disclaimer: I am not a physician and cannot offer any medical advice regarding fisting after an injury. If injured, you should make your own informed decisions regarding your future fisting activity.

After my surgery, I queried several people regarding the capacity to fist again. I group their advice into these three categories:

  • Medical Professionals
      • Key
      •  Gay/Homosexual
      •  Fister
    • General Surgeon - Intestine will return to normal, pre-surgical strength within three to six weeks, just like a cut on your external skin.
    • Gastroenterologist - All ass play (fucking, toys, fisting) should be limited to the rectum (nothing near or further than the injury itself).
    • Radiologist - Follow the advice of your gastroenterologist.
    • General Practitioner (PA) - Fisting at any level discouraged because lack of nerves and sensory system inside the GI Tract. Stitching could tear with large objects/pressure.
    • Gynocological/Pelvic Surgeon - Wait nine months to a year before having an internal examination by a fisting medical professional (for depth play). Permanent stitching should not be a problem.
    • Medical Assistant (Gastroenterology) - Wait at least six months for standard stitching, or a year for silk stitching to desolve. Fisters treated by our group that have returned to full fisting within 90 days of surgery have re-opened their wounds Stitching could tear with large objects/pressure.
  • Fisting Tops with 25 Years of Experience
    • Hand size: Small - Fisted four guys with injuries.
    • Hand size: Small - Fisted four guys with injuries very slowly, with some staying in rectum.
  • Fisting Bottoms with Perforations, Tears, or Ostomies
    • Colostomy in Sigmoid - Post injury fisting past repair site (also has four friends with similar injuries and fisting results).
    • Colostomy in Descending - Post injury fisting past repair site after three years.