Living and Dating With IBD
Getting diagnosed with inflammatory bowel disease (IBD) can be an unnerving experience. As a chronic condition—whether ulcerative colitis or Crohn's disease—your primary goal should be to keep the disease in a state of remission to best avoid inflammatory flare-ups.
As with physical and mental health, IBD can affect your sexual health, because the course of the disease, medication and possible surgery necessary for some people are not conducive to romance and passion. Certain symptoms, medications and surgeries can affect your sex drive and potentially cause erectile dysfunction (ED) in men.
IBD is an umbrella term for two conditions, colitis and Crohn's. Research cited by the Crohn's & Colitis Foundation indicates about 40 percent of IBD patients report the disease has prevented them from pursuing intimate relationships, and about 70 percent of patients say they have body image problems. Sexual dysfunction is reported by 52 percent of women and 20 percent of men with IBD, which are higher rates than those in the general population.
Symptoms and treatments
Aside from lifestyle changes, patients are typically prescribed various medications to help manage their symptoms and keep inflammation to a minimum. These medications include but are not limited to:
- Anti-inflammatory drugs
- Biological medications
- Immune modulators
These treatments are used to control and manage the symptoms of IBD, which typically include:
- Abdominal pain
- Bloody stools
- Chronic fatigue
Sometimes these symptoms can disrupt normal, everyday life, which is especially true if the patient is experiencing a flare-up.
"It's a constant struggle to live with IBD when you are in a flare," said Inna Melamed, Pharm.D., a functional medicine practitioner and gut and hormones expert in New Jersey and the bestselling author of "Crohn's and Colitis Fix" and "Digestive Reset." "You need to look for bathrooms when you are traveling and carry supportive meds and supplements always with you. Those that are in remission often must follow a strict diet and follow a very strict lifestyle. People do break down often and need additional psychological support."
Primary treatment plans don't always work, either, and not all patients respond to them in the same way. However, there's still hope, as having IBD is not a death sentence.
"Dating is an important part of life, and you should not miss out on all the fun because you have IBD," said Amani Kaite, a London-based nutritional therapist specializing in gut health. "Now, meeting potential romantic partners when you have IBD can be trickier because the disease can take a toll on your body image, confidence, mental health and emotional well-being. To make dating less stressful, please remember that you are not your IBD. IBD is a part of your life, but it does not define you."
Many people with IBD are under no misconceptions as they prepare for a date.
"Many of my clients with IBD are so prepared for dating," Melamed said. "There are always enzymes packed for dinner, and liver and digestive-supporting supplements are packed as well. They usually feel more comfortable sharing the information that they have inflammatory bowel disease early enough in dating, so it doesn't become awkward.
"Honesty is the best policy," she added. "Share your physical state and emotional state with them. It will only help build a stronger relationship if you are with the right partner."
Honesty and openness remain the best strategies for sufferers of IBD.
"The condition may impact your social life at some points, particularly when experiencing a flare-up of symptoms," said Orli Rhodes, a dietitian at King Edward VII's Hospital in London. "Many may find that they can't spontaneously commit to social plans, or need to think in advance about facilities available to them if they're going out or staying away from home.
"Honesty and openness can help friends and potential partners understand what you're going through, though," Rhodes continued. "Discussing your diagnosis—and the impact it has on your needs—can help to make social engagements feel less stressful and give your loved ones a better understanding of why you may need to cancel plans at the last moment or leave an event early."
However, it's still up to you how much information you want to disclose.
"Now, if you're dating, how much you tell your crush or even if you tell your crush about your condition, will be totally up to you," Kaite explained. "However, you will certainly improve your chances of successful dating by being open about your condition and being clear about your limitations when it comes to food and activities."
Managing your care
An IBD diagnosis can bring a rush of overwhelming emotions that you aren't ready to understand, Kaite said.
"This emotional shock is what I believe should be addressed first," Kaite said. "A great coping strategy is to try to restore a sense of safety and comfort. It is important that you don't put any pressure on yourself to 'just get on with it.' Take all the time you need to process the news. Go somewhere you feel safe and surround yourself with supportive people."
The most important aspect for patients to understand is that the treatment plan for the disease has come a long way, Melamed said.
"There are so many more food-accommodating options," Melamed said. "There are now acceptable bathroom passes. There are support groups and social media groups. There are psychologists that specialize in digestive disorders."
It's imperative to attend medical screenings and remain in touch with your healthcare professional on a regular basis.
"The state of inflammatory bowel disease may change throughout a patient's life," Rhodes said. "They may find that at certain points, such as during pregnancy, their symptoms change or worsen. Keeping in regular contact with your doctor and dietitian can help to manage these changes and prevent undue suffering. It's also advisable to regularly attend medical screenings you're invited to, but early detection and treatment are beneficial as you can start treatment immediately. If you are in remission, you should stay in touch with your GP [general practitioner] to avoid any long-term complications."
Some people with IBD experience mild symptoms and go years without any inflammatory spikes. On the other hand, despite advancements in treatment therapies (especially biological medications), a significant portion of patients with inflammatory bowel disease eventually require surgery.
Crohn's and Colitis Canada, a charity organization, reported about 80 percent of Crohn's disease patients and 20 percent of ulcerative colitis patients undergo surgery at some point in their lives.
"There are a few markers you can ask your doctor to monitor before the disease gets to the point where it needs an acute treatment," Melamed said. "For example, ANCA marker and tropomyosin increase up to 4.5 years before active disease. Monitoring these levels can be a way of prevention."
It's important to keep in mind that navigating IBD may not be easy, but having the right approach and support can help keep you in a state of remission to avoid as many inflammatory flare-ups as possible.
"If the inflammation cannot be controlled with diet and lifestyle changes, medication or other treatments, then the patient may need surgery," Kaite noted. "The damaged part of the bowel may need to be removed, but sometimes the strictures can be repaired without removing any portion of the intestines.
Some helpful resources include the Crohn's & Colitis Foundation in the United States and its sister sites in the United Kingdom and Canada. Another useful online resource is the Centers for Disease Control and Prevention (CDC).