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IBD: Issues With Body Image and Sexuality

IBD: Issues With Body Image and Sexuality. Impact of disease Perianal complications Draining cutaneous fistulae Skin lesions Arthritic deformities Pain Fatigue. Impact of treatment Surgical scars Stoma Medication side effects. IBD and Sexuality: Physical Impact. Affected aspects

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IBD: Issues With Body Image and Sexuality

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  1. IBD: Issues With Body Image and Sexuality

  2. Impact of disease Perianal complications Draining cutaneous fistulae Skin lesions Arthritic deformities Pain Fatigue Impact of treatment Surgical scars Stoma Medication side effects IBD and Sexuality: Physical Impact

  3. Affected aspects Behavior patterns Communication Sexual drive Sensations connected with sexual activity Negative effects Feeling dirty, unsexy, unattractive Reduced self-esteem Loss of former identity Anxiety over disclosure IBD and Sexuality: Psychological Impact

  4. Maintaining FemininityFollowing IBD Surgery • Body image • Sexuality • Communication • Fertility • Pregnancy

  5. Sexual Function Following IPAA • Usually improved because of improved general well-being • Some problems may continue • Dyspareunia • Vaginal drying • Sexual function improved 16%-25%1,2 • Frequency of intercourse increased 35%2 IPAA = ileal pouch-anal anastomosis. 1Farouk R, et al. Ann Surg. 2000;231:919-926. 2Damgaard B, et al. Dis Colon Rectum. 1995;38:286-289.

  6. Women With Restorative Proctocolectomies: Satisfaction With Sexual Relationships • 22% improved • 51% unchanged • 26% less satisfactory • Overall 86% moderately to extremely satisfied Bambrick M, et al. Dis Colon Rectum. 1996;39:610-614.

  7. Gynecologic Function Before and After IPAA Results of Questionnaire (n=110)1 *Rates range from 0% to 26%.2-5 1Counihan TC, et al. Dis Colon Rectum. 1994;37:1126-1129. 2Tiainen J, et al. Scand J Gastroenterol. 1999;34:185-188. 3Sjogren B, Peppen B. Acta Obstet Gynecol Scand. 1995;74:51-55. 4Damgaard B, et al. Dis Colon Rectum. 1995;38:286-289. 5Bambrick M, et al. Dis Colon Rectum. 1996;39:610-614.

  8. Women With Ileostomies: Sexual Function % Patients • No change 47% • Adversely affected 47% • Mild (22%) • Severe (14%) • Moderate (11%) • Improved 7% Awad RW, et al. Br J Surg. 1993;80:252-253.

  9. Women With Ileostomies: Sexual Concerns • Sexual attractiveness decreased 52% • Appliance 72% • Stoma 16% • Odor 4% • More women (60%) than men (52%) felt less desirable • Sexual intercourse is more difficult • Psychologically 46% • Physically 32% (n=50) Rolstad BS, et al. Dis Colon Rectum. 1983;26:170-171.

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