How IBD affects patients’ sexual health

Believe that the inflammatory bowel disease (IBD) impacts exclusively on the digestive system is a mistake. Beyond the gastrointestinal symptoms, this chronic pathology affects multiple spheres of the lives of those who suffer from it. This includes sexual health, an aspect that patients consider very important to maintain an optimal quality of life. However, it is often an underestimated and little-addressed issue.

“Although its impact on patients’ quality of life is considerable, sexual dysfunction is a rarely discussed topic in IBD. It is infrequently discussed both in medical literature and in consultations.”assures Marta Calvo, doctor attached to the Digestive System Service of the Puerta de Hierro University Hospital – Majadahonda and member of the Board of Directors of GETECCU. And adds: “About 300,000 people in Spain have IBD and the incidence is increasing year after year. And we are talking about a pathology that debuts in young people, generally between 15 and 40 years old, a stage in which sexuality, body image and Intimate relationships play an important role.”

IBD can cause several challenges in the sexual sphere. Physically, patients may suffer from diarrhea, abdominal pain, incontinence, perianal fistulas, and surgical scars, which can affect sexual desire and self-confidence. Furthermore, treatments such as corticosteroids can affect body image, including mood changes and adverse effects such as acne, which can all contribute to a decrease in libido. A significant percentage of patients not only have physical symptoms such as chronic fatigue and abdominal pain, but even more significantly, they also suffer from anxiety and depression, which can have an even greater impact on sexual dysfunction. These emotional factors often exacerbate the problem, more profoundly affecting the patient’s quality of life.

“Many times, patients feel embarrassed or believe that doctors don’t know how to help them. However, recent studies indicate that a high percentage of patients want to receive information about the impact of IBD on sexuality, and prefer that this information be provided at the time of diagnosis. Creating an environment of trust and support in the consultation is key so that patients feel comfortable talking about this sensitive topic.”says Dr. Calvo.

Resolving this issue involves promoting the fact that health professionals, especially gastroenterologists, carry out a comprehensive and personalized approach. “First, it is essential to identify individual risk factors, which may include previous surgeries, use of corticosteroids, abdominal or joint pain, incontinence and stress in relationships. Once identified, each symptom must be treated specifically. “Patients should also receive psychological support to manage depression, anxiety and stress associated with the disease.”emphasizes the specialist. And he adds: “It is crucial that the gastroenterologist collaborate with other specialists (nurses, gynecologists, urologists, surgeons, psychologists and sexologists) to address both the physical and emotional aspects of sexual dysfunction in IBD“.

The latest advances in IBD, in the focus of the 35th GETECCU National Meeting

With the aim of giving visibility and achieving progress in this area, Dr. Calvo will participate in the panel “Let’s talk about sex in IBD” during the 35th GETECCU National Meeting which will be held in Madrid from October 3 to 5. During this forum for updating and exchanging experiences, experts will discuss GETECCU’s main lines of work (research and teaching), advanced therapies, ongoing research projects or more specific topics such as coping with perianal disease or preventing IBD.

“Year after year, the GETECCU National Meeting consolidates itself as a reference space to learn about the evolution in the management of IBD in our country. This meeting not only allows us to share the latest advances in research and new treatment strategies, but also It also reinforces our commitment to teaching and training specialists, key to offering patients the best possible care. It is a unique opportunity to generate synergies between professionals, promote new lines of research and continue improving the quality of life of the people who care. live with IBD. These meetings are the engine that allows us to continue moving forward as a scientific and medical community.”assures Ana Gutierrez, president of GETECCU and head of the IBD Unit of the Digestive System Service of the Dr Balmis General University Hospital.

News and challenges in the approach to IBD

In the last ten years, science has made great strides in addressing the disease. Without a doubt, the great advances in the field of research have been the appearance of new drugs with different mechanisms of action and the studies that allow compare these new molecules with each other. “Currently, we have a fairly deep knowledge about IBD and, by better understanding the pathophysiology, we not only find new targets and can develop new treatments, but we also have other ingredients such as genetics, epigenetics or the environment”indicates Yamile Zabanavice president of GETECCU and assistant doctor of the Digestive System service at the Mútua Terrassa University Hospital. The specialist explains that therapeutic advances have also occurred in the field of immunology or in endoscopy research. “We have increasingly ambitious objectives: we want to achieve deep remission”he assures.

Regarding these objectives, the doctor emphasizes that another of the recent developments in the approach known as “treat to target”. “It means treating by objective and means that we are more demanding. Thus, we are no longer satisfied with the fact that the patient is well, but we set an objective and we go to achieve it. For example, when the objective is that the patient does not have lesions in the endoscopy, we change the treatment until we achieve it,” he points out.

For the specialist, The milestone that has revolutionized the treatment of IBD has been the arrival of TNF-alpha inhibitors (infliximab, adalimumab and golimumab) just over 20 years ago. “We had corticosteroids, thiopurines, methotrexate… but the arrival of these drugs was the first revolution from an antibody to a specific substance and, from here, we have seen a paradigm shift”says Zabana.

Added to these new features is the cyclical treatment of the disease: “We had always said that treatment for inflammatory bowel disease was a continuous, lifelong treatment. And now we know that, in certain patients, we could do cycles of treatment. This would keep them in remission without the side effects of immunosuppression maintained.

At GETECCU we work to allow more access to innovative therapies and, to this end, we promote studies that evaluate the way in which drugs modify the course of the disease.”emphasizes Yamile Zabana. “Our commitments include, for example, reducing dependence on corticosteroids or minimizing the risk of complications. To achieve this, we promote international collaboration, research with other groups, promote clinical trials and, in addition, share knowledge so that all people can benefit from these advances”he concludes.