N38 Male patients with Crohn's Disease and perianal fistulae and their experience of sexuality and dialogue with healthcare professionals about their sexuality - a qualitative interview study

Abstract

Abstract Background The incidence and prevalence of inflammatory bowel disease (IBD) has increased significantly over the last 30 years. IBD most often debuts in young adulthood and can have an impact on the patient's body image, intimate relationships and sexual function. The aim of this study was to explore how male patients with Crohn's disease and perianal fistulae, experience how their disease affects their sexuality, and how they experience the dialogue with healthcare professionals about sexuality and their related challenges. Methods A qualitative study based on a phenomenological hermeneutic approach was applied. Six male participants with Crohn's disease and perianal fistulae were recruited from an outpatient clinic at a regional hospital, Lillebaelt hospital, Vejle and Kolding. Data were collected via semi-structured telephone interviews. The transcribed interviews were analyzed using qualitative content analysis as described by Graneheim and Lundman. The analysis encompassed both a manifest and a latent level. Results The analysis led to the development of five themes: 1) The disease and sexuality. Flare-ups in the participants Crohn's disease posed an obstacle to intimacy, negatively affecting their sexlife during flare-ups. The participants used problem-focused and emotional coping strategies to overcome these limitations in their relationships, regarding intimacy and sex. 2) The phases of life - importance for sexuality. Sexuality was affected at different stages in life, independent of the participants' Crohn's disease. The balance with family, relationships, small children and work life, also had an impact on the participants desire for sex and intimacy with their partner and vice versa. 3) The importance of fistulas for sexlife. Acitive fistuala negatively affected the participants' sexuality. Their masculinity was affected by erectile dysfunction, which was a common complication to surgery. 4) Sexuality - an omitted topic in healthcare dialogue. Sexuality was often an omitted topic in the healthcare dialogue, even though the topic was important to the participants. 5) Is sex taboo? Sexuality was a topic the participants considered to be impacted by taboo, which encompassed both the participants and the health care professionals. Conclusion In patients with Crohn's disease and fistulae, sexuality must be seen in a bio-psycho-social perspective. Gender roles and coping strategies are important topics to include in the health care professionals dialogue with these patients.