Hyperosmolar lubricants include:
(1) Glynol II
(2) Conceptrol
(3) K-Y Plus
(4) K-Y Jelly
(5) Wet Original
(6) Astroglide
(7) ID Glide
(8) PrePair
The osmolality for these products range from 1,200 to 4,000 mOSm per kg. This can result in osmotic injury to the colonic epithelium.
Complications:
(1) epithelial injury along the distal 10 cm of the colon, which can lead to denudation of the mucosa
(2) decreased mucosal barrier to infectious agents such as HIV
(3) risk of chronic inflammation with proctitis and epithelial reactive changes
The risk of infection could also extend to the penetrating partner, since the receptive partner can leak body fluids across the inflamed mucosa.
Risk reduction:
(1) Use an iso-osmolar lubricant whenever possible.
(2) Avoid excessive and/or repetitive applications of a hyperosmolar lubricant.
(3) Avoid anal intercourse after use of a hyperosmolar enema (Fleet enema).
(4) Use a condom.
(5) Avoid multiple sexual partners.
