title: Comprehensive self-management reduces the negative impact of irritable bowel syndrome symptoms on sexual functioning.
abstract: BACKGROUND
  Women with irritable bowel syndrome (IBS) report sexual dysfunction. Comprehensive self-management (CSM) intervention has been shown to reduce gastrointestinal, psychological, and somatic symptoms in IBS women. Whether this intervention also reduces sexual dysfunction is not known.
  
  
  OBJECTIVE
  We sought to compare demographic and clinical factors in IBS women with and without sexual dysfunction as defined by the Arizona sexual experiences scale (ASEX) and to test the effects of CSM treatment on sexual dysfunction scores and on the sexual relations subscale of an IBS quality of life (IBSQOL) scale which measures the effect of IBS on sexual QOL.
  
  
  METHODS
  IBS (Rome II) women enrolled in a randomized clinical trial of CSM treatment were characterized as having sexual dysfunction (N = 89) or not (N = 86) at baseline based on ASEX criteria. Baseline characteristics and symptoms were compared between the two groups. Post-intervention changes were compared between the CSM and the usual care arms of the randomized trial.
  
  
  RESULTS
  Women meeting ASEX criteria for sexual dysfunction were older, had higher lifetime depression and antidepressant use, more primary care/MD visits, fewer mental healthcare visits, and greater sleep disturbance than those without sexual dysfunction. No significant group differences in gastrointestinal or somatic symptoms were observed. Compared with usual care treatment, CSM increased sexual QOL scores and had a weaker effect on ASEX scores.
  
  
  CONCLUSIONS
  Severity of IBS symptoms at baseline did not differ between IBS women with or without sexual dysfunction. The CSM intervention can reduce the effect of IBS on sexual QOL.
authors.affiliation: Department of Internal Medicine, Division of Gastroenterology, School of Medicine, University of Washington, Seattle, WA 98195-6424, USA. margarete@medicine.washington.edu
authors.forename: Margaret D
authors.initials: MD
authors.lastname: Eugenio
authors.forename: Sang-Eun
authors.initials: SE
authors.lastname: Jun
authors.forename: Kevin C
authors.initials: KC
authors.lastname: Cain
authors.forename: Monica E
authors.initials: ME
authors.lastname: Jarrett
authors.forename: Margaret M
authors.initials: MM
authors.lastname: Heitkemper
mesh_terms: D000328:Adult; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D043183:Irritable Bowel Syndrome / Q000150:complications* / Q000175:diagnosis / Q000523:psychology; D008875:Middle Aged; D010353:Patient Education as Topic / Q000379:methods; D011788:Quality of Life; D012016:Reference Values; D018570:Risk Assessment; D012648:Self Care / Q000379:methods*; D020018:Sexual Dysfunctions, Psychological / Q000209:etiology* / Q000503:physiopathology / Q000628:therapy*; D018434:Sickness Impact Profile; D013315:Stress, Psychological; D016896:Treatment Outcome