This can make having sex more uncomfortable, even painful

Some people choose to insert fingers, a sex toy or a penis into a stoma

Research on the effect of being given a stoma has found it can improve libido (desire) and sexual satisfaction for people with Crohn’s or Colitis – probably because people with a stoma no longer have many of the troublesome symptoms of Crohn’s or Colitis.

Some of the research on IPAA or ‘pouch surgery’ has shown that it can also have a positive effect on sexual functioning.

However, other studies have found that surgery ple, lead to increased tenderness of the abdominal wall or in the rectal area. It can also alter the position of the organs in the pelvis. As mentioned earlier, a different sexual position may also be able to give you useful advice.

In men, particularly those over 50, surgery to remove all or part of the bowel may occasionally cause or worsen difficulties with erections and with ejaculation. A small number of men with Crohn’s or Colitis may experience this sort of problem even without surgery (and of course it can also happen in men without Crohn’s or Colitis). These difficulties may be only temporary and may resolve over time. If they continue, it might be helpful to talk to your Crohn’s or Colitis or colorectal surgery team about referral for treatment, for example with medication (such as Viagra) or a penile implant.

For some people, the removal of the rectum can impact on their preferred sex activities, such as anal sex. For more information about this, see Crohn’s and Colitis and anal or oral important link sex .

They can also cause mood changes and depression, which may lead to loss of interest in sex

In anyone, surgery can affect not only our physical shape and how our bodies work but also how we feel about ourselves. See Feelings and emotions for more information.

I felt like a different person when I had the surgery. I didn’t like my scars or the fact that I now had a stoma. My husband told me the scars didn’t matter to him, and it made no difference to how he felt about me because the surgery had saved my life. I found this hard to believe until he asked what if it had been the other way round and he had the scars and the stoma. It made me realise that it wouldn’t change how I feel and I would still love him all the same.

Anal penetrative sex can be enjoyed by both men and women, using fingers, toy or a penis. Tenderness in the area due to Crohn’s or Colitis or following surgery, or the presence of perianal fistulas, may interrupt this practice.

Currently, there are no studies to indicate whether having penetrative anal sex might, for example, trigger a flare-up. There is also little guidance about how long you may need to wait after surgery to form an internal pouch, before having anal sex. However, your IBD team or surgeon should be able to advise you. They can also refer you for support from specialist counsellors, if you feel this would be helpful.

This is not recommended as the bowel attached to the stoma is quite thin and bendy. Penetration of the stoma could lead to serious bowel damage.

Some people practise oral-vaginal, oral-penile and oral-anal sex. You and your partner may feel concerned about this if your bowel cannot be guaranteed to behave well. The use of a dental dam (a small square of vinyl placed over the vulva or anus), provides a barrier for safer sex and would be able to advise you where you can buy these.

However, there is some evidence that steroids can affect sexual satisfaction. Other steroid side effects, such as weight gain, rounding of the face and acne may make you feel less desirable. Talk to your doctor if you are being affected in this way. A different steroid or a change in the way you take your medication may help reduce these side effects.