Only one in 10 healthcare professionals routinely ask their patients with inflammatory bowel disease about sexual issues – even though they can significantly affect quality of life in IBD and affect up to three quarters of patients during active disease.
NCA gastroenterologists Dr Anish Kuzhiyanjal and Professor Jimmy Limdi led the first multidisciplinary survey in the UK assessing healthcare professionals’ perceptions, practice, and barriers to addressing sexual function in Crohn’s disease and ulcerative colitis. The results have now been published in the Inflammatory Bowel Diseases journal.
Nearly 250 doctors, surgeons, nurses and other IBD staff responded to the survey, which identified lack of time or knowledge and unclear referral pathways as key barriers to discussion.
Many factors contribute to sexual issues in IBD, including disease-related factors such as disease activity, perianal involvement, surgery, and medication side effects, as well as depression, anxiety, fatigue, and body image.
Important issue
Previous research has shown this is highly important to people living with IBD and that they would expect it to be discussed from the time they are diagnosed.
Professor Limdi said: “Aside from a single study from the United States, there are virtually no data on healthcare professionals’ perceptions, attitudes, and barriers to discussion of sexual health-related issues among people living with IBD.
“While our survey showed gastroenterology colleagues were mostly comfortable discussing sexual health and agreed it should be covered, in practice it is very much neglected. In particular, the impact of IBD medication on sexual function was ‘not at all’ discussed by almost half of the respondents, although the impact of surgery was more likely to prompt a discussion.”
Those responding to the survey strongly felt that IBD specialists and IBD nurses should be responsible for talking about sexual health with their patients, although two thirds would also like clinical psychologists to be involved. However, most of the healthcare professionals said they didn’t have access to a clinical psychologist in their clinical team.
The authors say there is an urgent need to address the mismatch between patient expectations and reality, through collaborative work to develop guidance, accessible educational materials, and enhanced professional training.