If even sex plays against it, the situation becomes complicated. Even more so if the specialist does not always know how to meet you. This is true for various pathologies, worse if it is to be dealt with simultaneously with gastrointestinal manifestations and disorders of the sexual sphere that escape a precise classification. They can be of various kinds, but in this case to bring them to the fore as a joint problem are the hepatogastroenterologists. It would be them, so we read on Medscape, somewhat perplexed, hesitant to investigate the gender issue of their patients. They are the studies aimed at sparking a thematic reflection. And among these there is an Italian research presented at the European Congress of Hepato-Gastroenterology: it reveals that too many specialists do not know enough about the possible sexual problems of their patients, even when “the pathologies found could be the main sources of sexual disorders” . Possible? And why? The explanations provided are: modesty, lack of knowledge of the subject, or the patients themselves who do not feel like opening up to their doctor.
Men and women divided (also) by the intestine: all the fault of the brain
by Claudia Carucci
The Italian investigation
We start from the data. That of the many patients suffering from gastrointestinal disorders also afflicted by sexual dysfunctions, in turn responsible for stress and anxiety that affect their quality of life and / or that of their partners. Yet, precisely in the role of caregiver, hepatogastroenterologists could intuit the difficulties encountered by patients, but so far not much has been seen in the literature on this aspect. It was the Italian “communication”, exhibited at the congress, that gave back the picture of a situation that was, if nothing else, singular. And that is that although in this type of people there is a high prevalence of the sex problem, the specialists have proved too discreet in investigating.
Doctors who don’t ask
roman framefull professor of Hepatogastroenterology at the Vanvitelli University of Naples, is also the main author of the study carried out in collaboration with the Federico II Urology: “The truth is that more than 70% of the colleagues involved in the survey never, or only rarely, have raised this issue with their patients. Likewise, most of the latter have never confided in sexual issues during a visit to the gastroenterologist. “
The questionnaire with 29 questions
To evaluate attitudes, knowledge and practice models regarding sexual dysfunctions, a questionnaire with 29 questions was sent to young gastroenterologists or experts from the Italian Society of Gastroenterology and Digestive Endoscopy (Sige). The sender received 426 responses, mostly from experienced doctors (average age 47.2 years), while 21% were young practitioners (average age 29). Overall, 48% of respondents worked in a university hospital. In the Italian survey discussed at the congress, the reasons most often cited by professionals for not addressing a possible sexual dysfunction were lack of knowledge (58%), time (44%) and some embarrassment (30%). However, more than 70% of respondents admitted that specialist doctors should be able to manage sexual problems. And more than 80% said gastroenterologists should take courses dedicated to this type of problem.
And young people are even less available
Have the new generations of doctors been able to tackle the subject better? The result doesn’t change much. The study revealed that the percentage of young gastroenterologists who are unwilling to discuss sex with their patients is significantly higher than that of their more mature colleagues, i.e. the more experienced: 38.5% versus 21.3%. Furthermore, there is also a high percentage of young specialists who, compared to long-term gastroenterologists, reported that patients do not identify a potential link between their sexual dysfunction and the prescribed treatment (47.8% vs 32.5% ).
What is love? Science explains it
by Elisa Manacorda
Sexual function at risk
Impaired sexual function is more common in patients with chronic inflammatory bowel disease (IBD) than in the general population, according to a recent French study. The figure concerns approximately one in two women and one in six men. These are significantly higher levels than in healthy people, mostly determined by psychological factors and independent of the severity of the disease. The predictor of sexual dysfunction and erectile dysfunction (ED) was social and emotional involvement: anxiety in women and depression in men. The authors pointed out that most patients would have expected their gastroenterologist to consider this important aspect of their life.
When illness hinders an intimate relationship
A second European survey of IBD patients, conducted online among members of various patient associations, showed that 40% of the disease had hindered (if not prevented) the achievement of an intimate relationship. Again: A Spanish study reported that 40% of patients reported a negative influence of inflammatory bowel disease on their sex life. Furthermore, in every research, it has been confirmed that mood, digestive symptoms and fatigue are responsible for an altered quality of sexual life. These are three factors associated with IBD for which a therapeutic intervention should be hypothesized.
Irritable colon and sex life
Irritable bowel syndrome shouldn’t be overlooked either. Indeed, this also affects performance under the sheets. And it is an often underestimated factor, although many studies have shown that the disease affects libido, fatigue and sexuality in general. In the United States, another study found that irritable bowel can alter sexuality in two thirds of patients and sometimes negatively impact a partner’s life. From a work of Jean-Marc Sabate (gastroenterologist at the Avicenne hospital in Bobigny in France), conducted with the Association of patients with irritable bowel syndrome in 2016 (average age 46 years, mostly severe), it was found that sexual dysfunction is present in two thirds of women and that erectile dysfunction affects one in two men. And the couple’s quality of life was also at the expense. “In practice, we should often ask ourselves how it transforms into life as a couple, precisely because” sexual function is a fundamental component “, emphasizes Sabaté.
Belly pain, a symptom with many causes: but diet can help
by Giulia Masoero Regis
Sex and life as a couple are almost always exposed to the consequences of disease. “In many pathologies there is the possibility of an organic cause responsible for sex disorders – concludes Romano -. For example, hormonal factors, such as the low levels of testosterone found in subjects suffering from chronic liver disease in an advanced state, can negatively affect, in particular on a dysmetabolic basis. But also the endothelial (vascular) dysfunctions in patients with chronic inflammatory gastrointestinal diseases (ulcerative colitis and Crohn’s disease) can contribute to upset a normal intimate life for two “.