Sex and IBS

Friday, July 29, 2016


Dear Patrick: After years of discomfort and embarrassment, I have finally gotten an explanation for the problems I have been having with my digestive system. A specialist says that I have Irritable Bowel Syndrome (IBS). In order to control this condition, he has recommended a very limited diet and some medication. The thought of having to watch what I eat or take a pill every day is annoying. I regularly visit the gym, and I like to think of myself as a healthy person. But I have been in so much pain, I am willing to try anything. As you can imagine, one of the casualties of this condition has been my sex life.

IBS is unpredictable. I never know when I will have a bout of painful stomach cramps. Sometimes this is accompanied by nasty bouts of gas or diarrhea. Or I may have a few days when I am nauseated and irritable because I am constipated. Neither state makes me feel very sexy, and both types of IBS symptoms make intercourse uncomfortable.

My husband is one of those annoying people who never get sick. He doesn’t believe in IBS and thinks I “just need to relax and stop being a Type A personality.” Lectures from him on learning how to meditate or eliminating stress from my life just make me want to smack him. He expects to be able to continue to eat whatever he wants to eat no matter what my diet is, and he makes fun of the food plan my doctor gave me. He is also not at all sympathetic if I say I do not feel like having sex. It seems to me that he does nothing to support me. I am supposed to do whatever he wants so that his life is not affected by any problem that I have, no matter how serious it is.

I am so depressed about having this condition that I don’t know what to do. I am worn out by trying to continue to work when I feel so bad. The problems in my marriage are not making this any easier. Can I expect to get better? Do I need a new doctor? Do you have any suggestions for making sex easier?


Dear Bad Tummy: It sounds to me like you have more than one problem, although your letter focuses mostly on irritable bowel syndrome, or IBS. The first thing I want to tell you is that whether you are married or not, nobody has a right to expect sex from you when you don’t feel well, or if you don’t feel close to them, or you are just not in the mood. The selfish behavior your husband has displayed is causing a crisis in your marriage, and I’m sure that is not helping with your tummy problems.

Stress really does contribute to the physical problems of IBS. When a person feels emotionally upset, depressed, or under pressure to do things they don’t want to do, these emotions have a chemical reality that affect the body. Sympathy, care, and comfort from loved ones can often make a physical illness feel better or begin to heal because we feel loved and safe, and that’s good for the body. It sets up a physiological environment that doesn’t damage our health.

I don’t know how long ago your doctor diagnosed your illness and gave you the medication and a food plan. I also don’t know when you were supposed to go back for a follow-up visit. This can be a difficult condition to treat. There is no one-size-fits-all food plan, and the same thing goes for the medication. If you saw your doctor a few months ago and you see no improvement in your symptoms, make a new appointment. I hope you have been keeping a journal of what you ate and what your symptoms have been. That can be helpful to the doctor. Often, a meal plan is quite restricted in the beginning, to calm down the digestive tract and make sure you are only eating food your system can handle. Later on, foods might be added one at a time to see if they can be processed without causing symptoms. So don’t assume that a very restricted food plan is all you can eat for the rest of your life. That may or may not be true. Even if it is true, however, think about the fact that food can be medicine. Some of us need to eat to keep our bodies healthy, and we don’t get a lot of choice about what we can manage to digest.

If your husband needs to eat food that you can’t eat, he can cook it himself or order takeout. He is an adult, and all adults should be able to feed themselves. If you feel unable to tell him this, I would suggest that perhaps there is a problem in the relationship with you being able to say “no” to him. That alone is stressful because it means you can’t set any boundaries. With a selfish partner, that’s very important. He won’t care about figuring out what you need, he will only care about making sure he has what he wants. So you have to be strong enough to push back—or you need out of the relationship.

Get a counselor just so you have some one-on-one support for coping with the pain and embarrassment of these symptoms. There are therapists who specialize in helping people with medical challenges. Your counselor may be able to offer you assertiveness training, self-hypnosis, or many other techniques to help you to figure out what your options are and feel more in control.

Once your symptoms are reduced, you may find that you want to resume sexual activity. I recommend, however, that you write down all the reasons why you want to have sex—not your husband. Eventually, you might want to share that information with him. If he can’t give you what you want to make sex worth your while, there’s no good reason for you to satisfy him.

This is an extreme point of view, but he has been rather extreme with you. I think deep down he is denying the reality of your symptoms because he is afraid to lose you. Any acknowledgement that you are physically vulnerable makes him fear for your mortality. If he could get in touch with that and say that, you might be able to forgive some of his childish behavior. But until he can, let’s not look for excuses for him. Let’s press on toward balancing the equation and helping you to feel better. I vote for spa days, massages, and anything else that will lighten your load. Having to work when you have IBS is miserable. I wish we lived in a world where everyone had the benefits to be able to take time off for recovery when a serious problem like this comes up.  

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