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Anal douches present a viable option for males and females attempting anal sex.

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However, these occurrences are rare in healthy, sober adults.

Internal bleeding or rupture may leave the individual exposed to infections from intestinal bacteria.

The enema tube and solution may stimulate the vagus nerve, which may trigger an arrhythmia such as bradycardia.

Enemas should not be used if there is an undiagnosed abdominal pain since the peristalsis of the bowel can cause an inflamed appendix to rupture.

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Blood resulting from tears in the colon may not always be visible, but can be distinguished if the feces are unusually dark or have a red hue.

If intestinal rupture is suspected, medical assistance should be obtained immediately.

According to sex historians, homosexual males needed a means for cleaning their anuses before sex.

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