A major fear for many people with Crohn’s or Colitis is that they might have an ‘accident’ (for example, a bout of diarrhoea) during sex. Even if it doesn’t happen, the constant worry about the possibility of it happening can be very off-putting. For men, the anxiety may cause difficulty with getting an erection.
You may find going to the toilet and emptying your bowel before sex makes you feel more confident about avoiding an ‘accident.’ Taking an anti-diarrhoeal medicine, such as loperamide (Imodium/Arret) before sex may also help you control your bowel. However, these sorts of anti-diarrhoeals are not suitable for everyone with Crohn’s or Colitis, and should not be taken during a flare-up, so check with your d before buying a supply.
You may also feel more confident if you and your partner try and have sex at the times of day when your bowel is less active.
If you are particularly worried about incontinence during intercourse, ask your d to refer you to a continence specialist. They will be able to advise you about other ways to manage this problem.
Abdominal pain
Crohn’s and Colitis can cause chronic (ongoing) abdominal pain and tenderness. It may be easier to control the level of movement and penetration during sex if you are the one on top. Talk to your IBD team about ways to manage your pain, and whether painkilling medicine might be useful. However, some types of painkillers, such as non-steroidal anti-inflammatory drugs (NSAIDS) which include aspirin, ibuprofen and diclofenac, are not recommended for people with Crohn’s or Colitis.
The amount of contact you have with healthcare professionals such as your GP and your hospital IBD team will depend on the severity of your Crohn’s or Colitis and your response to treatment.
If you are lesbian, gay, bisexual or transgender, you may worry about interacting with medical and nursing staff, particularly if they don’t know your sexual orientation. But healthcare practitioners, including IBD nurses, receive guidance about the needs of lesbian, gay, bisexual and transgender people, so should understand how to support you.
You may feel nervous about being open about your sexual practices or sexual orientation, especially as you may feel very vulnerable if you are unwell. However, if you can be open at the beginning of your relationship with healthcare professionals, it may make your future experiences with them easier.
Whatever your sexual preference, you may find having your partner with you during appointments may help to make you feel more supported, and they can remind you afterwards of what was said
When I was first diagnosed, I never felt confident enough to be open about being gay. But I have since learnt that it is important to be open and honest with people, because you are much more likely to be able to get the support you need.
Surgery for Crohn’s or Colitis can often involve removal of part of the small intestine or part or all of the colon and rectum. This may result in an ileostomy or colostomy, or, for Ulcerative Colitis, the creation of an internal ileo-anal pouch (IPAA). For more detail on common operations for Crohn’s or Colitis, see our information on Surgery for Crohn’s Disease and Surgery for Ulcerative Colitis.
It is very common for people facing stoma surgery to be worried about how it might affect their relationships. Everyone and every relationship is different and it will take time for you and your partner to get used to living with your stoma. But it will gradually become part of your lives. However, in general, having a stoma bag should not be a barrier to having an active sex life. Many people with a stoma have fulfilling sex lives. Provided the stoma bag is attached securely it should not be affected by the sexual position you choose. There are also different types and sizes of bag available, designed to be much more discreet than the usual options.