Anonymous Self Perception Survey of Sexuality and Body Image in Inflammatory Bowel Disease

Introduction: Inflammatory Bowel Disease (IBD) is a debilitating disease that affects young individuals as they develop socialization skills and explore their sexuality. Validated scales of sexual function in IBD are lacking. The standard of care tool utilized is the Sexual Function Questionnaire (SFQ), which compared healthy controls to cancer patients. The Body Image Scale (BIS) is the only previously validated scale in IBD patients. We hypothesized that surgery and/or longer duration of IBD would negatively impact sexual function and body image. We applied the SFQ and BIS as an anonymous survey to a female IBD-dedicated organization to assess sexual function and body image satisfaction. Methods: 183 women completed an anonymous online survey comprised of the SFQ and BIS scales. SFQ scores were calculated for 9 sub-categories with an Overall Composite Score and Impact Score. The historical SFQ control group and the validated BIS scores in female IBD patients served as our population's comparator. Results: Females with IBD scored 14.7% lower in overall sexual function compared to the historical control group (p < 0.001). Relative to these controls, our cohort showed poorer function in: Interest (22%), Desire (35%), Orgasm (19%), Satisfaction (18%), Activity (35%), and Physical Problems (19%) (all p < 0.001). Masturbation scores improved 94% compared to the healthy controls (p < 0.001). There was no statistically significant difference in Relationship or Arousal subscores. Within the IBD cohort, women treated with surgery reported more physical difficulty with sex including pain, tightness, and dryness (p < 0.001). Duration of IBD symptoms and time since diagnosis were both positively correlated with Physical Problems (p< 0.05), and duration of symptoms was negatively correlated with sexual Interest (p < 0.05). IBD women on steroids had a greater Impact score suggesting greater difficulty in adapting to their illness (p < 0.05). Surgery, steroids, biologic drugs and longer duration of IBD symptoms or diagnosis did not alter body image. Conclusion: Many areas of sexuality, including overall sexual function were impaired in women with IBD. Despite this impairment, patients with IBD did not demonstrate more conflict in Relationships or Arousal compared to healthy controls. Time of diagnosis, steroids, and surgery negatively affected Physical Problems and sexual Interest. Notably, biologics, steroids, surgery and disease duration did not affect their Body Image Satisfaction.Figure