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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.
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 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.