Kevin Ashby, MD, tells Michele Jordan
I became a doctor because I knew it stimulated the intellect, and I wanted to help people. I truly believe in treating my patients like family. As a board-certified gastroenterologist, I treat people with a variety of digestive issues—some mild, others more serious. I have seen many people with Crohn’s disease, an inflammatory bowel disease that affects the digestive system. It can cause many symptoms, from abdominal pain and frequent diarrhea to bloating and fatigue.
I have worked in this field for many years and I have heard about the various problems that accompany this disease. Most people talk to me about the physical effects, but Crohn’s disease can affect many areas of an individual’s life as well.
this is a sensitive topic
One area that Crohn’s disease can affect is a person’s sex life. Many patients are reluctant to talk about intimate relationships and how Crohn’s disease interferes with their social lives. Because of this, they often don’t get the help they need. On the other hand, some patients are happy to talk about how their disease affects their private lives. As physicians, we understand this is a sensitive topic for some and can help. People with Crohn’s disease are able to be emotionally and physically close. To ensure a certain level of comfort, there are a few things to consider.
Whenever stomach problems cause patients to need to go to the bathroom frequently (as in Crohn’s disease), it can have an impact on sex and dating. Some patients worry about the flare and the challenges it may pose to their social life.
People sometimes forget that Crohn’s disease is a systemic disease — meaning it affects the entire body, not just the digestive system. People with Crohn’s disease may experience lethargy (or fatigue), weakness, swelling, some rectal bleeding, and it can affect the skin, eyes, and other organs of the body. Crohn’s disease can also affect the urinary tract. Some symptoms may cause changes in hormone levels or other symptoms that may affect libido.
Women with Crohn’s disease may experience dyspareunia, which is pain during intercourse.
The effect of Crohn’s disease on energy levels is also a factor. It’s hard to be motivated to date or have an active sex life when you’re not feeling well. My patients talk about how it prevents them from dining out with friends or engaging in other activities that might help build long-term relationships.
The physical effects of Crohn’s disease on intimate relationships are one thing, but I’ve seen some emotional effects too. There may be some negative perceptions of body image, embarrassment about the urgency or frequency of needing to use the bathroom, and in more extreme cases some depression. Not wanting to go out and socialize or form relationships can be emotionally depressing.
Crohn’s disease can affect your daily life, and coping with the disease can be very difficult for some people. It can be life changing and unpredictable. Fear of having to suddenly go to the bathroom can take a toll on some people. Managing symptoms while trying to maintain an intimate life can be incredibly stressful.
Since the symptoms of Crohn’s disease — especially the urgency of needing to go to the bathroom — can be unpredictable, some patients have to get creative with their dating lives and intimate relationships. I have patients who say they prefer to go to restaurants that don’t have spicy food so they don’t have to go to the bathroom. Some of my patients who say they don’t enjoy doing anything food related may suggest a walk in the park or something similar instead of meeting at a restaurant. Instead of going to a date’s house, many people with Crohn’s disease may suggest meeting in their own home, with access to their own bathroom and privacy.
In general, sex is safe for people with Crohn’s disease, and I generally do not advise patients to avoid intercourse unless it hurts. Anal sex can be painful after certain procedures for Crohn’s disease. A swollen flare can make some positions uncomfortable. While I don’t hear this often, it can happen. When this happens, I advise my patients to stop having sex until the problem causing the pain is resolved. That’s the only time I advise people not to have sex with Crohn’s disease – when it’s painful. In this case, pain can be their guide.
there is still hope
Some have expressed concerns about how therapy might affect intimate relationships. I haven’t seen that many. The main problem with newer drugs is the risk of infection, but I haven’t seen this affecting the intimate lives of patients.
Over the past 10 years or so, many new drugs for Crohn’s disease have emerged. These drugs have revolutionized the lives of many Crohn’s patients and their management of the disease. These drugs have resulted in improved symptoms and greatly improved quality of life for many patients. Some of these newer drugs can help reduce bathroom trips, abdominal pain and energy levels. They help many of my patients feel better overall. I’m excited to see how these treatments enable often-suffering patients to do things they might have stopped doing before.
Please discuss your options with your doctor. Your medical support team can help you with physical issues that may affect your relationship.
If my patients are struggling with sex, intimacy, or dating because of Crohn’s disease, here are a few other tips I would suggest to them:
- Talk to your partner. You might be surprised that some of the things you worry about aren’t such a big deal to them. I haven’t had any partners come in and complain, which probably says a lot!That doesn’t mean these problems don’t exist, but they may not be as important as the people with them Crohn’s disease Might think they are.
- If you have a stoma/ostomy bag, sex should not affect your stoma/ostomy bag, but patients should consider changing it before sex to avoid any potential confusion. There are many products on the market to hold the pouch in place, as well as clothing to cover your stoma and pouch.
- Discuss with your doctor whether you can take antidiarrheal medication before sex or going out on a date.It may buy you some time if your bowel movements are unpredictable as they may be related to Crohn’s disease.
- Think about the different ways you can maintain intimacy outside of sex. For whatever reason, traditional sex may not be right for you at the time, but talk to your partner about other ways you can express your mutual affection.
- Consider getting extra help. In addition to talking to your gastroenterologist, talk to a sex therapist or counselor if what you’ve tried so far doesn’t work.some doctors who specialize Crohn’s disease Illness can also provide additional solutions.