P301 Gender influencing attitudes to inflammatory bowel disease: a questionnaire investigating the effect of IBD on body-image, sexual function, and family planning
K. Boland*, M. Forry, N. Godwin, E. Tatro, F. E. Murray, G. C. Harewood, S. Patchett, A. O Toole
Beaumont Hospital, Department of Gastroenterology and Hepatology, Dublin, Ireland
Inflammatory bowel disease (IBD) is associated with impaired sexual function in women, and it may drive negative perception of body-image. Further, knowledge of IBD and its effects on fertility and inheritance may lead to the phenomenon of voluntary childlessness. Enabling patients to make decisions about pregnancy and childbirth involves close interaction and education from healthcare teams to achieve the best outcomes for patients and their children.
The effects of IBD on body-awareness, sexual intercourse, and ease of discussion with healthcare teams were determined. We evaluated knowledge of the effect of IBD and therapeutics on fertility, pregnancy, and breast feeding. We then determined the influence of IBD on family planning and attitudes to pregnancy. These were assessed through distribution of a gender-specific questionnaire using a 5-point Likert scale (score of 1 = strongly disagreed that IBD affected these attitudes, and a score of 5 strongly agree).
In total, 66 return outpatients with confirmed IBD completed these questionnaires. 53% (n = 35) were men. Only 3 patients recruited were >60 years. We scored attitudes to body-image and effect of IBD on sexual function. We found that men < 32 years recorded that IBD had a negative effect on body perception and sexual function in comparison to men > 32 years (p = 0.01, Wilcoxon-Rank Sum). All women were affected equally in terms of body-image, irrespective of age group, with a mean score of 2.98. Further, body-image in men < 32 years was negatively affected in a statistically significant manner in comparison with women < 32 years (p < 0.001, Wilcoxon-Rank Sum). We then analysed questions relating to patients knowledge of IBD and pregnancy, breastfeeding, and genetic predisposition amongst children of patients. We found that lower knowledge scores correlated with negative attitudes, reports of restriction of family size, and even voluntary childlessness in men (p = 0.26, Spearman coefficient), but not in women. Women strongly agreed that patients should never breastfeed with any IBD medications (mean score 4.5), but men and women were neutral when asked if surgery had any effect on fertility (mean score 2.75)
Female patients within our service seem to have improved knowledge of the effect of IBD on their health and pregnancy, although there are gaps in knowledge relating to surgery for IBD and breastfeeding. However, men are significantly less knowledgeable in this respect. Further, IBD has a significantly greater negative influence on body-image and sexual function in men < 32 years. These data suggest that our patient-education service might need to empower both genders, ultimately enabling full participation in care plans and complex joint decision making.