Introduction

The irritable bowel syndrome (IBS) is often associated with significant symptoms affecting areas outside the gut - sleep disturbances, loss or increase in appetite, changes in body weight, and sexual problems; these changes can add to the misery of IBS itself. Interestingly, they are also seen in patients with another so-called 'functional gastrointestinal disorder': non-ulcer dyspepsia, or indigestion (NUD). A study done a few years ago tried to find out just how common sex problems were in patients with IBS and NUD, compared with healthy people. Here's a summary of their report.

What was done

Patients referred to the University of California (Los Angeles) Center for Functional Bowel Disease and Abdominal Pain were studied. They were mostly white, well-off, and well-educated. Those who had a firm diagnosis of IBS or NUD were included in the study. There were 683 of them, and their responses to questionnaires were compared with those of 247 healthy people from the surrounding community.

Among the 'healthy' control group, there were 47 who had symptoms signifying IBS who had not sought medical treatment, and 10 who had NUD symptoms who had also not sought treatment. These 'non-patients' were also analyzed for their frequency of sexual problems.

The sexual function questionnaire asked about any problems with sexual function in the previous 6 months. The types of difficulty included were: decreased sex drive (or libido), pain during intercourse, gastrointestinal symptoms directly preventing intercourse, and worsening of sexual problems during periods of aggravation of bowel symptoms.

An additional questionnaire was used to assess psychological symptoms, focusing on anxiety and depression, as these are often reported by patients with IBS and NUD.

What was found

There were more women in the patient group, and this group was slightly older, than the normal volunteers. Adjustments were made in the analyses to compensate for these slight differences between the groups.

Problem of sexual function were reported by 43% of the patients and 16% of the normal volunteers (not counting the 57 'healthy' people who had symptoms of IBS or NUD but who hadn't seen a physician about them). After adjusting for the differences in age and sex, it was found that people with IBS or NUD were over 4 times as likely as healthy people to have sexual problems.

Sexual problems were as common in the IBS patients as in those with NUD. The most frequent difficulty in both patients and normal volunteers was decreased sex drive, followed by pain on intercourse (which was more common in women than in men).

The worse the symptoms of IBS or NUD, the more frequent were sexual problems. And for those patients with IBS, sex problems were roughly twice as common in those with constipation as in those with diarrhea.

Symptoms of anxiety or depression were not more common in patients with IBS or NUD than in the normal volunteers.

Comment

This study shows that people diagnosed with IBS or NUD are 4 times as likely to have sexual problems as healthy people. (In the case of IBS, constipation-affected patients were more likely to have these difficulties as the diarrhea-prone.)

The most common type of sexual difficulty was decreased sex drive, regardless of age or gender. This is a feature of other chronic disorders, such as diabetes, arthritis, and Parkinson's disease.

Since this study was published in 1998, new, effective drugs have become available to treat IBS: alosetron for diarrhea-predominant IBS and tegaserod for constipation-predominant IBS. It would be interesting to see (in a clinical trial) whether taking one or other of them would improve the sex life of afflicted patients.