Врачи объяснили, как болезнь Крона влияет на интимную жизнь и поиск партнера

Men are often taught to aim for control of not just their lives and emotions, but also their bodies. So it makes sense that some guys with inflammatory bowel diseases like Crohn’s—which causes symptoms like diarrhea, vomiting, nausea, bloating, and mouth and anal sores—can feel downright undatable. “We live in a culture that prioritizes control, perfection, effortlessness, and bodies that appear predictable and contained,” says Carolina Pataky, LMFT, a licensed marriage and family therapist and a co-founder of South Florida’s Love Discovery Institute. When people with Crohn’s internalize those societal messages, “people can begin to believe that their body makes them less desirable or too complicated to love,” she says. Dating with Crohn’s may require a little more planning around things like food choices or bathroom accessibility, says board-certified gastroenterologist Pratima Dibba, MD, with Medical Offices of Manhattan. But it doesn’t disqualify anyone with the disease from having a fulfilling dating or sex life, she says. After all, everyone has something about their body that they feel self-conscious about around potential partners, whether it’s another chronic condition or a disability, a skin condition or hair loss, or something like erectile dysfunction or infertility. Still, for the roughly 1 million people in the U.S. with Crohn’s, dating does come with a few unique considerations. The business of disclosure While Crohn’s disease symptoms can be managed with medication and lifestyle interventions, the condition cannot be cured. If you’re trying to find a long-term partner, you’re ultimately looking for someone who is going to support and love you through the ebbs and flows of your disease, not just when remission makes it easier for you to be out and about. Pragmatically that means it’s worth considering when and how you share your diagnosis. “There is no universal right time,” says mental health expert and sex therapist Jesse Kahn, LCSW, a certified sex therapist and director of the Gender & Sexuality Therapy Center in New York City. “Disclosure of your diagnosis is about your comfort and what feels relevant to the level of connection you’re building,” they say. Some people like to put phrases like “chronic illness stud,” “chronie,” or other references to their diagnosis directly in their online-dating bios so anyone who matches with them knows from the start. Others prefer to wait until they’ve sussed out whether there is enough chemistry or baseline compatibility to warrant divulging more about their health. Either way remember you’re neither making a confession nor burdening your plus-one by discussing your diagnosis. You are simply sharing information about your life—and you should present it as such, says Dr. Pataky. “If you share it with an apology or over-explanation, it can reinforce the belief that something is wrong,” she says. “But if you share it with clarity and groundedness, it becomes part of a broader story about who you are.” One thing that’s easy to overlook: Disclosure isn’t just about sharing intel, but gathering it too. “Someone’s response gives you real-time information about their availability and capacity for empathy, flexibility, and respect,” says Kahn. “Dating with a chronic illness often requires adapting plans, managing uncertainty, and showing care throughout changing circumstances,” they say. If a potential partner responds with curiosity and compassion, you’ve learned something encouraging. And if they respond with irritation, judgment, or resentment, you’ve discovered something just as important. Either way you’ll have a better idea of whether they’re someone you actually want to build a relationship with. A foundation of self-love An expert telling you you’re worthy of love is one thing; believing it deep in your bones is another. Developing that kind of self-confidence in an ableist world takes time and intention—but it’s essential for choosing partners you can establish healthy and happy connections with. “Confidence often grows from being in spaces where your body is reflected back to you as worthy and desirable, not something to change or fix,” says Kahn. That might involve taking steps like curating your social feeds to be affirming spaces; connecting with other people with Crohn’s disease online and IRL; joining broader communities with, by, or for disabled and chronically ill people; or working with a therapist who understands body image through a nonableist lens, they say. Becoming more self-assured also means learning to trust your body instead of fighting it, says Kahn. While Crohn’s doesn’t have to make you a hermit, pushing yourself to go on dates, stay out late, or have sex when you’re experiencing a flare or running on empty can erode your sense of safety and trust in your own body, they say. By contrast, honoring your body’s needs is a way to practice the kind of self-respect that lets you show up more authentically, comfortably, and confidently while dating. Managing medication side effects Crohn’s disease affects dating and sex differently from person to person, in part because its impacts can be felt anywhere along the digestive tract, from the mouth to the anus, says gastroenterologist Carlton Thomas, MD, who gives tips on living with inflammatory bowel diseases on his TikTok and Instagram. Where the inflammation occurs influences everything from the symptoms someone experiences to the treatments needed to achieve remission, he says. Some people with milder forms of the disease can manage their symptoms with dietary changes and other lifestyle modifications. Still, many people with Crohn’s require prescription medications—including oral drugs, injections, infusions, or a combination of therapies—to reduce inflammation and maintain remission, says Dr. Thomas. The rub? Those treatments can come with side effects that may throw a wrench into dating. Fatigue and nausea are common, according to Dr. Dibba, while some medications may increase the risk of infection. “Certain treatments can also affect sexual function,” she says. If libido or arousal are affected, Dr. Thomas strongly recommends bringing it up with your doctor. There are a range of medications available, and in some cases providers may be able to switch you to another option that supports remission without robbing you of sexual pleasure and desire. Adding a sex therapist to your care team can also help you navigate any emotional impacts that changes in desire may have, as well as offer advice on adapting your sexual activities to accommodate symptoms or side effects, Kahn says. Crohn’s-friendly dates At the heart of any good date is an activity that provides mutual enjoyment. For folks with Crohn’s disease, that means ensuring the activity, location, and timing all fit your body’s needs that day. If you’re in remission, chances are you’ll have few, if any, limitations. But if you’re experiencing a flare—or simply aren’t sure how your body will cooperate—you’ll want to make plans that leave room for flexibility, whether that’s choosing a restaurant with foods you know agree with you, ensuring you have easy restroom access, or deciding on an outing that can easily be shortened or rescheduled, says Kahn. Unless you enjoy being in the driver’s seat for all dates, you shouldn’t shoulder the weight of planning alone, says Courtney Glashow, LCSW, a psychotherapist and founder of Anchor Therapy in Hoboken, New Jersey. Sure, early in a relationship you may need to share the kinds of dates that work best for you at different stages of the disease. But as time goes on, a supportive partner should begin anticipating those needs without being asked every time, she says. “A partner who’s actually a partner will pick up on what you need over time and start coming up with ideas on their own,” Glashow says. “If they get defensive when you ask for that kind of teamwork, that says a lot.” The sex question For many people sex is an important part of a romantic relationship. Let there be no doubt: A Crohn’s disease diagnosis doesn’t need to stand in the way of the spicier parts of dating. “When you’re in remission and your disease is well controlled, everything from kissing to penetrative sex is generally safe,” Dr. Thomas says. “I even have patients with Crohn’s who participate in sexual practices like receptive anal fisting during remission.” It’s also worth noting that Crohn’s disease is not contagious. “It is safe to have sexual intercourse with someone who has Crohn’s disease,” Dr. Dibba says. “Crohn’s disease is not contagious, so its physical manifestations cannot be transmitted.” However, that doesn’t mean every sexual activity will feel good at every stage of the disease. During a flare the question might not be “Can I?” but “Do I even want to?” Mouth sores may make kissing uncomfortable, while rectal inflammation or fissures can make receptive anal sex painful or inadvisable, explains Dr. Dibba. Fatigue and GI symptoms, meanwhile, can cause any sexual activity to feel unappealing. Rather than trying to push through symptoms, Dr. Thomas encourages people to let their bodies guide their experience. That might look like modifying the kind of sexual interaction you’re having or pausing physical intimacy until symptoms improve and opting for intellectual or emotional intimacy in the meantime.