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.

体验愉快的性活动的能力对人类健康很重要。接受性肛交（RAI）是一种常见但经常受到污名化的令人愉悦的性活动。人们对结肠、直肠和肛门疾病及其治疗如何影响 RAI 知之甚少。由于症状和治疗相关毒性作用的不可预测性，对胃肠道疾病进行 RAI 可能很困难。患者可能会出现括约肌张力过高、胃肠道症状特异性焦虑、​​结构性疾病引起的盆腔血流改变、癌症定向治疗引起的感觉下降或造口产生的身体形象问题。这些可能会导致 RAI 问题，包括性交疼痛（疼痛性 RAI）、性唤起功能障碍、性高潮功能障碍和性欲下降。对于患有胃肠道疾病和/或治疗相关功能障碍的患者，针对有问题的 RAI 的治疗策略包括骨盆底肌肉强化和伸展、心理干预和恢复装置。为医疗保健专业人员提供一个框架来讨论令人愉悦的 RAI 和诊断有问题的 RAI 可以帮助改善患者的治疗结果。使 RAI 正常化、肯定 RAI 带来的快感并承认胃肠系统与性快感、性功能和性健康有关，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。