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Sex and Inflammatory Bowel Disease

Sex and Inflammatory Bowel Disease

Rita was happy about this weekend away with her husband, Stan. It was the first time they could really relax together, now that she had recovered from her surgery. After a long road with inflammatory bowel disease (IBD) – ulcerative colitis, in her case – she was feeling energetic and optimistic again.

Stan had found a quaint bed and breakfast by the ocean and they were enjoying drinks on the deck. But they had some quiet time too. And during those moments, Rita felt nervous about the evening.

She and Stan hadn’t been intimate since her surgery. Now that she was better, her doctor said it was fine to start having sex again. She and Stan were both eager. But with her colon and rectum removed, she was extremely self-conscious about her colostomy bag. Stan had seen it in the hospital, but how would he feel about it now? Would he still think she was attractive? Would he be disgusted if it leaked? Would it come off? Would it make noise?

She had voiced these concerns to Stan, who said none of that mattered to him and that they could take their time. Rita wasn’t sure if he was just saying that, though.

Many people with inflammatory bowel disease share Rita’s concerns. IBD can affect sex and relationships, both physically and emotionally. However, with some adjustments, patients and partners can still enjoy satisfying sex.

What is IBD?

IBD is a chronic condition marked by inflammation of the digestive tract, which includes the large and small intestines and the rectum. People with IBD often have diarrhea, pain, cramping, and bloody stools. Fatigue is another common symptom.

Generally, IBD falls into two categories: ulcerative colitis and Crohn’s disease. Experts aren’t sure what causes these illnesses, and some people have more severe cases than others. Sometimes, IBD can be managed with lifestyle changes and medications. But sometimes, parts of the digestive tract need to be removed. Some patients need to wear a collection pouch (a colostomy bag) after surgery because they can no longer move their bowels as they used to.

How does IBD affect sexuality?

IBD can present some physical and emotional challenges to sex.

Pain and cramping might make some positions uncomfortable. Some women experience vaginal and rectal pain, especially if abdominal organs have shifted during surgery. Nerves may also be damaged during surgery, which can reduce sensation in the clitoris. Men with IBD may develop erectile dysfunction or trouble with ejaculation.

Fatigue can also make sex problematic. Many people with IBD find that they are just too tired for intimacy.

Not surprisingly, chronic pain from IBD can leave patients depressed and anxious, and anticipating pain during sex can make it difficult to relax and enjoy the experience. Some couples start to avoid sex and their relationships suffer.

Patients may also be concerned about their partner’s reaction if an accident occurs during sex, such stool passing or a leaky collection pouch. Many feel unattractive with a colostomy bag. Single people may not want to pursue new relationships because they feel embarrassed or don’t know how to bring up the subject with a prospective partner.

Tips for Coping

IBD might make sex challenging, but issues can be resolved with communication and planning.

·         Talk to your partner. We say this a lot here at SexHealthMatters, but communication is key. If you have IBD, be open with your partner about how you’re feeling. If you don’t feel up to having sex, it’s okay to say so. If a certain activity hurts, speak up and suggest other options. If you worry about accidents or appearance, mention that too. Your partner should understand and will most likely want to reassure you.

·         Make yourself comfortable – physically and emotionally. Work with your partner to determine which sexual activities are most comfortable and pleasurable. If you wear a colostomy bag, change it before sex and be sure the new bag is secure. If you feel self-conscious about visual changes to your body, try wearing a long T-shirt or specialty underwear. You might also consider soft lighting, romantic music, or anything else that helps you relax.

·         Ask your doctor about treatment for sexual problems. For example, men who develop erectile dysfunction have a number of treatment options.

·         Find support. It can be helpful to talk to other people with IBD who can share their experiences, answer questions, and make recommendations. Your doctor can probably suggest a support group near you. You might also find listings online or consider starting one of your own.

·         If you’re single, don’t let IBD stop you from dating. Remember that your next partner will like you for who you are. When you feel ready for intimacy, be honest about your concerns.

·         Consider therapy. If you’re feeling depressed or anxious about your IBD, a mental health professional can help you work through these feelings. Sex therapy is another option if you and your partner are having difficulty discussing the sexual changes in your relationship.


Colostomy Association

“Living with a Colostomy – Relationships”

Crohn’s and Colitis Foundation of America

“The Intimate Relationship of Sex and IBD”

(May 1, 2012)

International Society for Sexual Medicine

“Can inflammatory bowel disease (IBD) affect a person’s sex life?”

Mayo Clinic

“Inflammatory bowel disease – definition”

(February 18, 2015)

“Inflammatory bowel disease – treatments and drugs”

(February 18, 2015)


“Inflammatory Bowel Disease and Sex”