Disease activity and erectile dysfunction in Japanese patients with ulcerative colitis

Sexual satisfaction and associated factors among patients with inflammatory bowel disease in Japan

AIM

This study aimed to identify sexual satisfaction and related factors in Japanese patients with inflammatory bowel disease, as well as the characteristics of patients who refrained from responding to the sexual satisfaction question.

METHODS

A questionnaire survey was administered to 499 patients, of whom 492 were available for the analysis. Sexual satisfaction was measured using 5-point scale derived from "I am satisfied with my sex life" item in the Functional Assessment of Chronic Illness Therapy-Fatigue. Patient characteristics (sex, age, marital status, and job status) were collected. Additionally, we obtained data from the scale regarding nonresponse to the sexual satisfaction, sleep deprivation status, emotional well-being, and fatigue subscales, and collected information on disease status from the medical records, including the partial Mayo Score and Crohn's Disease Activity Index.

RESULTS

Regarding sex life satisfaction, the most common response was somewhat (24.8%). There were 173 (35.2%) patients who refrained from answering the sexual satisfaction question. Females and those of older age tended to avoid answering the question. Impaired sexual satisfaction was also significantly associated with older age, sleep deprivation, low emotional well-being subscale scores, and greater effects of fatigue.

CONCLUSION

Sexual satisfaction is related to chronic conditions in such areas as emotional well-being, fatigue, and sleep deprivation in inflammatory bowel disease patients, even when they are in remission. These results suggest that patients with inflammatory bowel disease are sometimes reluctant to talk about sex. Therefore, it is important for medical staff to consider this issue, especially in Japan.

Association between bowel movement frequency and erectile dysfunction in patients with ulcerative colitis: a cross-sectional study

The association between ulcerative colitis (UC) and erectile dysfunction (ED) has been previously reported. Numerous previous studies have also reported an association between gastrointestinal symptoms and ED. Constipation and diarrhea are common in patients with UC. However, the specific association between bowel movement frequency and ED remains unclear. The aim of this study is to investigate the association between bowel movement frequency and ED in 164 patients with UC. The definition of ED, moderate to severe ED, and severe ED was the Sexual Health Inventory for Men score <22, <12, and <8, respectively. Bowel movement frequency was divided into three categories: (1) high (More than once a day), (2) normal (once a day, reference), and low (less than one time/day). The definition of constipation was based on the Rome I criteria and/or medication for constipation. The prevalence of constipation and ED was 10.4% and 86.0%, respectively. The rate of high, normal, and low bowel movement frequency was 56.1%, 25.0%, and 18.9%, respectively. High bowel movement frequency was independently and positively associated with ED and moderate to severe ED (ED: adjusted odds ratio [OR] 4.42, 95% confidence interval [CI] 1.35-15.98; moderate to severe: adjusted OR 2.98, 95% CI 1.22-7.61). Low bowel movement frequency was independently and positively associated with moderate to severe ED and severe ED (moderate to severe: adjusted OR 3.96, 95% CI 1.27-13.08; severe: adjusted OR 3.20, 95% CI 1.08-9.86). No association between constipation and ED was found. In conclusion, in Japanese patients with UC, both high and low bowel movement frequency were independently and positively associated with ED.

Serum albumin levels as a useful complementary marker for erectile dysfunction in ulcerative colitis: A cross-sectional study

OBJECTIVE

Recently, a close association between ulcerative colitis (UC) and erectile dysfunction (ED) was reported. An inverse relationship between serum albumin and ED is found in patients with chronic disease. However, the association between serum albumin levels and ED in patients with UC is unclear. This study aims to investigate this issue in Japanese patients with UC.

METHODS

One hundred and thirty-six Japanese male UC patients were enrolled in this study. Information on serum albumin levels and medications for UC from medical records, Sexual Health Inventory for Men (SHIM) score information from self-administered questionnaires and information on the severity of UC from physician reports were obtained from medical records, self-administered questionnaires, and reports from physicians. The participants were divided into tertiles based on the total protein, serum globulin, serum albumin, aspartate aminotransferase, and C-reactive protein levels. The definition of ED and severe ED was SHIM score < 22 and SHIM score < 8, respectively. The association between these serum markers and ED was assessed by multivariate logistic regression.

RESULTS

The prevalence of severe ED in the low, moderate, and high albumin groups was 66.0%, 51.0%, and 28.3%, respectively. After adjusting for confounding factors, the low albumin group was independently and positively associated with severe ED (adjusted odds ratio: 2.74, 95% confidence interval: 1.03-7.48, p for trend =0.044). No association between other marker and ED was found.

CONCLUSION

Serum albumin was independently inversely associated with severe ED in Japanese patients with UC. Hypoalbuminemia might be a useful complementary marker for assessing the prevalence and severity of ED in UC patients.