Maintaining a satisfying sex life can be a particularly difficult challenge. Body image issues that result from scarring after surgery, ostomy bags, and fistula around the anal and genital area can make sex painful and take an emotional toll on your sexual self-esteem. Fear of bowel accidents or the sudden need to rush to the bathroom in the middle of an erotic encounter can dampen your enthusiasm for sex, intimacy, or affection.

Introduction
Mental struggles
Sex is a very important part of life for many of us. But those with inflammatory bowel disease IBD can find the condition makes getting intimate a little more challenging. We chat to Paula, who has Crohn's, about banishing blushes and not letting IBD get in the way of having a great time in the bedroom. Most of us are bad enough at talking about sex. But when normal intimacy worries are combined with concerns about bowel incontinence , it's even harder to open up. Luckily year-old Paula, who has Crohn's disease , is no shrinking violet. At least, certainly not the type of Crohn's I've got with recto-vaginal fistulas.
Video Transcript
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As a registered nurse and sexual health educator, I am familiar with the association between sexuality and overall physical and emotional health. Your health is your wealth. When a disease threatens your health, it affects your quality of life and your sexual health. These are chronic conditions that can affect both physical and mental health. IBD can result in diarrhea, significant pelvic and abdominal pain, and unintended weight loss.