Calling Dr. DG . . . Rimming Risks

[+ honcho]

Being suddenly single again, I'd be grateful for any comments you might have on a topic that has been weighing on my mind lately.

 

I recently rented some time with a leather 'scort visiting from LA, who in the course of letting me worship his frontside and balls with my mouth, spread his legs in a clear invitation to visit his perineum [sp?] and other nether regions.

 

Although the idea squicks me a whole lot less than it used, I'm still concerned about health risks involved. Common knowledge has it that risk of contracting HIV that way is very small, and of course, it is possible to get vaccinated against Hepatitus A & B, but what about Hepatitus C?

 

(This insidious virus can be a "silent" infection for years, slowly causing major damage to one's liver without giving much outward in the way of symptoms).

 

I've also read (in the Scientific American) that many stomach ulcers are actually caused by a bacterium, which while not fatal, would certainly be unpleasant.

 

Are you willing to comment on any other risks and the degree of likelihood?

 

aTdHvAaNnKcSe

 

{I had a really good time with the aforementioned escort - Tom Southern - but didn't think I'd have any new information to bring to the table that couldn't be found in any of the existing reviews)

[Guest Dr. DG]

The Risks of Rimming

 

Rimming is not the benign sexual activity that some men assume. It is as dangerous in some respects as unprotected anal intercourse or shared needles, etc. The major risks are for HIV, hepatitis A/B/C, herpes, Helicobacter pylori (the bacterium implicated in stomach ulcers), gonorrhea/syphilis/chlamydia, and many other pathogens which can be nasty in both immunocompromised and immunocompetent men. Hepatitis C has no cure, has no vaccine (at this point), and the patient may live only 6 to 10 years following diagnosis if certain conditions are met. The risk of HIV is not small either. I know what you are thinking: God! Here he goes again with the safer sex talk, but I truly care about the men in our community and my professional ethics and moral values do not permit me to advocate practices which are potentially harmful.

 

If you would like to rim that escort's beautiful bum, consider cutting a rubber in half (lengthwise) and using that as a barrier protection against his asshole. Conversely, use a piece of plastic wrap--it's much cheaper and may be (but not proven in clinical studies) somewhat effective in helping to prevent the spread of dangerous STD pathogens. Saran wrap is thicker and I have used it myself--the plastic has a greater chemical density and theoretically offers better barrier protection, but that remains to be proven. Don't use aluminum foil--it tastes awful and the crinkling noise really distracts from the sensuous mood (okay...really bad joke).

 

Please consider the point that Hepatitis C is a very real, very dangerous disease that has no cure, no vaccine, and little treatment options at this time.

 

Thank you so much for listening...believe me I am flattered that my meager little advice has found a willing audience here!

[Guest jeejer]

calling Dr. DG again-risks involved in finger play

 

Are the risks the same then for finger play involving the butt? any safe ways to play?

[CT Dick]

RE: calling Dr. DG again-risks involved in finger play

 

Are the risks any less with less penetration? i.e. licking around the hole but not inserting the tongue?

[Guest icon513]

RE: The Risks of Rimming

 

Doctor,

 

I can certainly see the risks of contracting all the diseases you mention should one come into contact with fecal matter, which can contain blood in addition to bacteria and viable viruses.

 

But when talking about rimming, I don't think anyone here is referring to a dirty asshole. We're talking about assholes that have been thoroughly washed since the last time they were used for defecation.

 

So, where is the significant risk in licking a clean asshole?

 

As for actually inserting one's tongue, under normal conditions I can't imagine any normal person being able to get it in far enough to actually come into contact with fecal material that might be in the rectum -- especially since most gay men pay particular attention to anal cleanliness when bathing (i.e., cleaning the inside of the anus with a soapy finger).

 

So, assuming a clean partner, don't you think that using dental dams or other types of barriers for rimming is a bit beyond the call of duty? I mean, as safe as most of us believe we are, the majority of us (I think) regularly French kiss and perform at least some oral without a condom (avoiding cum and precum in the mouth). Does rimming a clean partner put us all that more at risk?

[Guest cincyaryea]

RE: The Risks of Rimming

 

Please keep in mind that washing just serves to dilute the bacterial/viral load. Given the 3 dimensional structure of the organs involved it is impossible to get it perfectly clean. Use of antibacterial soaps are not adequate protection either. Certainly rimming IMMEDIATELY after thorough washing reduces the risk but does not eliminate it.

 

For the reader asking about finger play. I am not aware of any studies. The risk is probably low, but don't forget that hang nails, cuts, scratches etc. all offer possible routes of infection. I wouldn't be paranoid, but I would wash thorougly as soon as practicle thereafter.

[Guest NYCMuscBoy]

RE: The Risks of Rimming

 

A friend who I played with about six months ago contacted me with the scary news that he'd come down with a case of amoebas. It could have come from me, or I could have received them from him, so he wanted to let me know. (We'd engaged in some mutual rimming over the course of our play.)

 

He'd started taking some poisonous-feeling medication to get rid of them.

 

I went to my doctor and was tested via not-fun stool sample, and thank GOD came out negative. My friend, however, cannot get rid of them, even with the horrible medication, and has lost a considerable amount of weight. He was not a big guy to begin with, so it's scary.

 

I love to rim, but my days of that are over -- be careful, guys!

[Guest Dr. DG]

RE: The Risks of Rimming

 

While I know most gay men are fastidious about cleaning their perianal areas, the risks of rimming remain the same whether or not you use a scrub brush up your ass. Unfortunately, the writer (cincyaryea) is correct in that washing only dilutes bacterial, viral and miscellaneous pathogen load and is therefore not a reliable method of avoiding STDs.

 

As for the infection with amoebae, there are many amebic pathogens with two particular species (E. histolytica and D. fragilis (that's a very old name--terminology might have changed)) that are well-known for causing potentially life-threatening hepatic (liver) infections even in otherwise healthy patients. Treatment is generally with two or more drugs (paromomycin and metronidazole with or without additional antiparasitics) for a prolonged period (three or more weeks) along with hepatic biopsies and other monitoring. Amebic pathogens are spread largely by what is termed an oral/anal route including rimming, unprotected intercourse and drinking/consuming contaminated food and water.

 

As for the risks associated with ungloved fingering of an anus, the risks are primarily as set forth by cincyaryea. Fingernails, rough skin, abrasions, micro-minature tears in flesh, etc. are all potential routes for spreading infection, although definitive clinical literature remains conspicuously absent in this area.

 

Cincyaryea had it mostly correct, however the use of antibacterial soap (with appropriate mechanical scrubbing and rinsing) found in a grocery store may help to reduce the bacterial and viral load to make rimming with a condom cut in half lengthwise or a piece of high-density plastic wrap less risky than using no protection at all. The use of surgical scrub, while somewhat distasteful to some (and certainly potentially toxic if not rinsed off properly and ingested), will help control the risk a little more. I am afraid that most of this is largely conjecture from many practitioners who participate in discussions at various HIV and infectious diseases conferences and clinical literature is woefully lacking. I cannot vouch for all of this information but to say that it sounds reasonable based on what I know of microbiology and current health care research.

 

To sound like my usual safer-sex-self, I do not advocate any practice which would put any person at risk in any way. Just be careful and remember...just because you can does not mean you should.

 

Thanks for letting me rattle on about these topics, I do appreciate your kindness in allowing me to voice my opinions.

[Guest torjon]

RE: The Risks of Rimming

 

Who can logically argue with any of the good doctors points? But man, does this "reality prescription" take a lot of the fun out of this sport of ours! When it becomes necessary to kiss through saran wrap, I think I'll just turn in my slut license and go back to the "straight and narrow" life I had before.. the one I didn't know was dull until I moved outside it. Goodbye, sweet buns....

[Guest torjon]

RE: The Risks of Rimming

 

Who can logically argue with any of the good doctors points? But man, does this "reality prescription" take a lot of the fun out of this sport of ours! When it becomes necessary to kiss through saran wrap, I think I'll just turn in my slut license and go back to the "straight and narrow" life I had before.. the one I didn't know was dull until I moved outside it. Goodbye, sweet buns....

[Guest torjon]

RE: The Risks of Rimming

 

Who can logically argue with any of the good doctors points? But man, does this "reality prescription" take a lot of the fun out of this sport of ours! When it becomes necessary to kiss through saran wrap, I think I'll just turn in my slut license and go back to the "straight and narrow" life I had before.. the one I didn't know was dull until I moved outside it. Goodbye, sweet buns....

[Guest cleverock]

RE: The Risks of Rimming

 

Doc---Was surprised that you mentioned the whole spectrum of Hepatitis in relation to rimming. My understanding (and I know a lot of people in a public health) is that Hep A is definitely a risk with rimming. The epidemiology of Hep C is not well-established beyond sharing needles---and the risk not attributable to needles is belived to represent people uncomfortable reporting injection drug use (it's easier to ask folks about screwing someone of the same sex). hep B wouldn't surpise me, but are you being a bit speculative about B & C (not that you've given us plenty to legitimately worry about).

[Guest Dr. DG]

RE: The Risks of Rimming

 

The hepatitis B and C risks associated with rimming are largely based on two important anatomical and physiological features of the digestive tract: 1) it is highly laced with blood vessels, particularly capillaries which may leak even small amounts of blood (and therefore virus particles) into the rectum for transmission; and 2) digestive epithelium (tissue) is rapidly growing and may slough off during even very light contact, and even very small amounts of blood may be released during rimming potentially transferring a virus. The truth about Hep C is that not much is known about its method of transmission, but blood and the oral/fecal route have not been totally eliminated. I have treated patients who have contracted both from multiple sexual partners, and rimming played a considerable role in the potential route of infection.

 

Unfortunately, in medicine there are certainties outside of birth and death. The connection between oral:anal contact and existence of multiple types of hepatitis in some patients has been reasonably established in clinical literature such as case reports. Further clinical research is necessary.

 

Thanks!

[Guest Dr. DG]

RE: The Risks of Rimming

 

Sorry...my notebook acted up before I had a chance to edit the last comment.

 

It should have read:

 

Unfortunately, in medicine there are few certainties outside of life and death. The association between different forms of hepatitis and oral:anal contact has been established in some types of clinical literature including case reports. I have treated patients with hepatitis C who had no visible signs of intravenous drug addiction or use. Based on the lack of uniform epidimiological data and on a general knowledge of digestive tract anatomy and physiology, I do not believe that an association between rimming and the potential spread of Hepatitis B and C can be totally or reasonably eliminated.

[+ Lucky]

Hooville History Post

 

Before we had Unicorn, we had Dr. DG to help out with medical advice. I don't know what happened to him that he left the site.

[NYTomcat]

Before we had Unicorn, we had Dr. DG to help out with medical advice. I don't know what happened to him that he left the site.

 

Im loving these Hooville history lessons. Thanks Lucky always good to know your history.

[+ glutes]

It is expensive, and nasty to take...

 

http://www.shopeastwest.com/med/upload/Flagyl400.jpg

[MsGuy]

History lessons or doctor's pills, glutes?

[+ glutes]

Not a personal experience, had some medical training...

[Luv2play]

It is expensive, and nasty to take...

 

http://www.shopeastwest.com/med/upload/Flagyl400.jpg

 

Maybe, but it works. I once had to take it and can swear by its efficacy!

[adriano46]

Not a personal experience, had some medical training...

 

And sadly, after a pretty interesting rimming session with a widely discussed escort here... I had 4 weeks of fighting parasites and finally had to take Flagyl.... so I can speak from experience.

[Luv2play]

Did you ever post a review?

[adriano46]

Did you ever post a review?

 

Review was posted BEFORE I was diagnosed. Given all the %$#$% in the USA on HIPA laws, dare not even go there on this public forum. I did privately and confidentially inform the guy in question of my symptoms - he got pretty upset with me so I dropped it. ... Swallowed my pills, felt sick for a week or so... and dropped it. Obviously I would never call him again.