Perceived Sexual Dysfunction amongst Patients with Inflammatory Bowel Disease

Abstract

300 patients with inflammatory bowel disease (IBD) were randomly selected from the community-based register held in Leicester. They were invited to participate in a study investigating personal problems of patients with IBD. 188 patients agreed to participate and were subsequently sent a previously validated questionnaire. A similar questionnaire was sent to buddy controls of similar age, sex and background (n = 76) as well as matched controls drawn at random from general practitioner lists (n = 46). Details sought included demographic data, patients’ perception of their disease severity, data relating to treatment, family history, fertility, frequency of sexual intercourse and the effect IBD had on personal relationships. 150 questionnaires were returned from patients (response rate 80%) and 122 from controls. The reliability of a randomly selected group of questionnaires was assessed by direct interview 4 months after the main study (n = 20). There were no demographic differences between the patient and control groups (age: t = 0.67, ns; duration of marriage: t = 0.92, and marital status/ number with a regular partner: χ² = 14, 12 d.f., p = 0.3). Dyspareunia was commoner amongst patients (n = 15, 38%) than controls (n = 7, 18%), although this was not statistically significant (z = 2.6). There was no significant difference in the overall frequency of sexual intercourse amongst patient and control groups (χ² = 12.78, 12 d.f.), even when comparing those with infrequent or no sexual intercourse (χ² = 6.98, 4 d.f.) The reliability of these results was confirmed after 4 months when there was no difference in resposnes in the re-interviewed group. Although there is no statistical evidence of a decreased frequency of sexual intercourse amongst men with IBD and women with ulcer-ative colitis they cite similar difficulties to women with Crohn’s disease, including fear of faecal incontinence (n = 17), abdominal pain (n = 13) and urgency (n = 11). Consequently there is a need to investigate the problems of patients with IBD sympathetically and refer them to the appropriate professional agencies.

Fertility and pregnancy in inflammatory bowel disease

“…Advances in surgical technique have decreased although not eliminated postoperative sexual dysfunction, and this seems to apply to both conventional proctocolectomy and pouch surgery with a reported incidence of impotence of around 4%-8% [6] . It is important to remember that patients are often quite reluctant to discuss such delicate matters and tactful prompting and adequate time during the consultation is the key to their detection.…”

Management of inflammatory bowel disease in the pregnant patient

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general population due to relationship difficulties, body image problems, fear of pregnancy and inappropriate medical advice that pregnancy might be dangerous [1][2][3] . Pregnancy planning should be discussed with the patient and her partner early on prior to conception.

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Interação da gestação na atividade da doença inflamatória intestinal e sua influência sobre o prognóstico gestacional e na fecundidade

“…As causas mais prováveis para os casais não terem filhos são a dificuldade de relacionamento, problemas com a imagem corporal, medo de engravidar e aconselhamento médico inapropriado, conforme apontado por outros autores [52][53][54].…”

“…Portanto, trata-se na maioria das vezes da escolha da paciente e não a impossibilidade de conceber conforme já referido na literatura por diversos autores [7,24,[52][53][54].…”