title: Female gender and surgery impair relationships, body image, and sexuality in inflammatory bowel disease: patient perceptions.
abstract: BACKGROUND
  There is a paucity of literature on the impact of inflammatory bowel disease (IBD) on relationships, body image, and sexual function from a patient perspective. This study sought to describe patients' perceptions of these issues.
  
  
  METHODS
  In all, 347 patients, age 18-50 years, from a hospital-based IBD database were surveyed by post. Quantitative and qualitative data were obtained on demographics, relationships, quality of life (QoL), body image, and sexual function. Comparisons were made by diagnosis, gender, and operative status. Univariate and multivariable analyses and logistic regressions were performed; P < 0.05 was regarded as significant.
  
  
  RESULTS
  The response rate was 62.5%. Overall, 88.5% reported impaired QoL; 50.2% a negative effect on relationship status; and 66.8% impaired body image (females 74.8% versus males 51.4%, P = 0.0007; operated 81.4% versus nonoperated 51.3%, P = 0.0003). A greater proportion of women reported decreased frequency of sexual activity, as did operated subjects (female 66.3% versus male 40.5%, P < 0.0001; operated 68.5% versus nonoperated 50.4%, P = 0.0113). Women and operated subjects also more often reported decreased libido (female 67.1% versus male 41.9% P = 0.0005; operated 67.4% versus nonoperated 52.6%, P = 0.035). 9.7% omitted medication because of perceived negative effect(s) on sexual function. Logistic regression revealed that female gender negatively affected body image, libido, and sexual activity, while limited resection surgery negatively affected body image (all P < 0.005).
  
  
  CONCLUSIONS
  A large proportion of patients perceive IBD to negatively affect many aspects of sexuality. Females and operated subjects more frequently perceived these negative effects. These findings are important in overall clinical care of patients with IBD and should be addressed.
authors.affiliation: Southern Adelaide IBD Service, Flinders Medical Centre, Bedford Park, South Australia. katermuller@yahoo.com.au
authors.forename: Kate R
authors.initials: KR
authors.lastname: Muller
authors.forename: Ruth
authors.initials: R
authors.lastname: Prosser
authors.forename: Peter
authors.initials: P
authors.lastname: Bampton
authors.forename: Reme
authors.initials: R
authors.lastname: Mountifield
authors.forename: Jane M
authors.initials: JM
authors.lastname: Andrews
mesh_terms: D000223:Adaptation, Psychological; D000293:Adolescent; D000328:Adult; D001294:Attitude to Health; D001828:Body Image; D005260:Female; D006801:Humans; D015212:Inflammatory Bowel Diseases / Q000523:psychology* / Q000601:surgery; D008297:Male; D008393:Marriage / Q000523:psychology*; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D010361:Patients / Q000523:psychology*; D010465:Perception; D011379:Prognosis; D011788:Quality of Life; D012649:Self Concept; D012737:Sex Factors; D019529:Sexuality / Q000523:psychology*; D011795:Surveys and Questionnaires; D055815:Young Adult