Abstract：
The ability to experience pleasurable sexual activity is important for human health. Receptive anal intercourse (RAI) is a common, though frequently stigmatized, pleasurable sexual activity. Little is known about how diseases of the colon, rectum, and anus and their treatments affect RAI. Engaging in RAI with gastrointestinal disease can be difficult due to the unpredictability of symptoms and treatment-related toxic effects. Patients might experience sphincter hypertonicity, gastrointestinal symptom-specific anxiety, altered pelvic blood flow from structural disorders, decreased sensation from cancer-directed therapies or body image issues from stoma creation. These can result in problematic RAI - encompassing anodyspareunia (painful RAI), arousal dysfunction, orgasm dysfunction and decreased sexual desire. Therapeutic strategies for problematic RAI in patients living with gastrointestinal diseases and/or treatment-related dysfunction include pelvic floor muscle strengthening and stretching, psychological interventions, and restorative devices. Providing health-care professionals with a framework to discuss pleasurable RAI and diagnose problematic RAI can help improve patient outcomes. Normalizing RAI, affirming pleasure from RAI and acknowledging that the gastrointestinal system is involved in sexual pleasure, sexual function and sexual health will help transform the scientific paradigm of sexual health to one that is more just and equitable.
摘要：
体验愉快的性活动的能力对人类健康很重要。肛交（RAI）是一种常见的，尽管经常受到污名化，愉快的性活动。对结肠疾病知之甚少，直肠,和肛门及其治疗会影响RAI。由于症状的不可预测性和治疗相关的毒性作用，参与RAI与胃肠道疾病可能很困难。患者可能会出现括约肌高渗性，胃肠道症状特异性焦虑，结构性疾病改变了盆腔血流，癌症导向疗法引起的感觉下降或造口产生的身体形象问题。这些可能导致有问题的RAI-包括性交困难（疼痛的RAI），唤醒功能障碍，性高潮功能障碍和性欲下降。患有胃肠道疾病和/或治疗相关功能障碍的患者有问题的RAI的治疗策略包括盆底肌肉加强和伸展，心理干预,和修复装置。为医疗保健专业人员提供一个框架来讨论愉快的RAI和诊断有问题的RAI可以帮助改善患者的预后。使RAI正常化,确认RAI的快感，并承认胃肠系统参与性快感，性功能和性健康将有助于将性健康的科学范式转变为更加公正和公平的范式。
