{
  "abstract": "Introduction Sexual health is an under-recognised but important component of quality of life in ulcerative colitis (UC). While inflammatory activity and psychological factors are often implicated, the contribution of bowel control symptoms such as urgency and faecal incontinence remains poorly characterised.Methods We performed a cross-sectional analysis of adults with UC who completed the validated ICIQ-IBD questionnaire to quantify the prevalence of sexual impact and identify independent clinical and psychological factors associated with moderate–severe sexual impact. Sexual impact was assessed using item Q28, evaluating restriction of sexual activity due to bowel control symptoms (0-4), with moderate–severe impact defined a priori as a score ≥2 during the usual/remission phase. Bowel urgency (BU) and faecal incontinence (FI) were derived from ICIQ-IBD items. Irritable bowel syndrome (IBS) was defined using the Rome IV diagnostic questions. Disease activity was defined using a hierarchical composite prioritising faecal calprotectin (FCP >250 µg/g) where available, with IBD-Control used when FCP was missing. Anxiety and depression were analysed as continuous Hospital Anxiety and Depression Scale scores. Multivariable logistic regression was performed, with sensitivity analyses adjusting for age and sex.Results Among 267 patients with UC, sexual impact data were available for 218; 44% had active UC based on composite definition. Median age was 50.5 years (IQR 36–59.8), and 51% were female. BU was reported by 56%, FI by 73%, and Rome IV IBS by 30%. Sexual impact was common, affecting 43% during usual/remission and 73% during worst/relapse phase. Sexual impact during usual/remission was substantially more prevalent in patients with BU (59.5% vs 21.6%) and FI (53.1% vs 13.8%).In multivariable analysis, BU (adjusted OR 2.8, 95% CI 1.4–5.5, p=0.005), FI (adjusted OR 3.6, 95% CI 1.5–8.3, p=0.006), and higher depression scores (adjusted OR 1.17 per point, 95% CI 1.05–1.31, p=0.004) were independently associated with moderate–severe sexual impact. Disease activity, Rome IV IBS, anxiety scores, age, and sex were not independently associated with sexual impact.Conclusions Sexual impact in UC is common and persists even during remission. It is driven primarily by bowel control symptoms, particularly urgency and faecal incontinence, rather than inflammatory disease activity. These findings highlight the need for routine assessment and targeted management of bowel control symptoms to address sexual health in UC care.Abstract FP12 Figure 1",
  "authors": [
    {
      "affiliations": [
        "Northern Care Alliance NHS Foundation Trust, Manchester, United Kingdom"
      ],
      "name": "Jimmy Limdi"
    },
    {
      "affiliations": [
        "Oxford University Hospitals, Oxford, United Kingdom"
      ],
      "name": "Gaurav Nigam"
    },
    {
      "affiliations": [
        "University of Manchester, Manchester, United Kingdom"
      ],
      "name": "Shaheen Hamdy"
    },
    {
      "affiliations": [
        "Manchester University NHS Foundation Trust, Manchester, United Kingdom"
      ],
      "name": "Dipesh Vasant"
    },
    {
      "affiliations": [
        "Northern Care Alliance NHS Foundation Trust, Manchester, United Kingdom"
      ],
      "name": "Anish Kuriakose Kuzhiyanjal"
    }
  ],
  "title": "FP12 Sexual dysfunction in ulcerative colitis is driven by bowel urgency and faecal incontinence rather than inflammatory activity",
  "uid": "1a5d849a-bca6-543b-b62d-685c7eb1eea1"
}