The Effect of Perianal Disease on Quality of Life, Fecal Incontinence, and Sexual Function in Crohn’s disease patients

Purpose To evaluate the impact of perianal Crohn’s disease (PCD) activity on quality of life (QoL), fecal continence, and sexual function in patients with Crohn’s disease (CD), and to identify factors associated with impaired patient-reported outcomes. Methods A cross-sectional analytical study was conducted, from an existing CD patient database at Shaare Zedek Medical Center who diagnosed with and without perianal disease and were seen in IBD clinic between June 2023 to August 2024.The patients agreed to participate and answered validated questionnaires that assessed QoL (SIBDQ), fecal incontinence (WEXNER), and sexual function (IIEF for men, FSFI for women). A total of 150 CD patients were recruited, including 47 with PCD (active and non-active) and 103 without PCD. Results Patients with active PCD had significantly lower QoL compared to those with non-active PCD and without PCD (p = 0.001). Two major risk factors for decreased QoL were identified: age over 40 (p = 0.024) and only conservative treatment (without chronic medication) (p = 0.031). Although no significant difference was found in fecal incontinence between groups, 64.2% of PCD patients reported some degree of incontinence. Sexual function scores were lower in PCD patients, particularly women, though the difference was not statistically significant. Conclusions Active PCD significantly reduces QoL in CD patients, with older age and absence of chronic treatment contributing to poorer outcomes. These findings highlight the need for optimized treatment strategies to improve patient well-being. Further research should explore additional clinical and psychological aspects affecting CD patients with perianal involvement.