What to Tell Your Gastroenterologist

Most people with inflammatory bowel disease (IBD) see their gastroenterologist on a regular basis. The relationship between a gastroenterologist and a patient with IBD tends to be close, because ulcerative colitis and Crohn's disease are chronic, lifelong conditions. IBD goes through periods of active disease and remission, which means that it needs to be watched, even when it's not causing any outward signs or symptoms.


I Want to Trust You & Not Feel Embarassed

Doctor Examining Patients Abdomen

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 Even though many people with IBD keep their gastroenterologist very close, they may not tell their gastroenterologist everything. This could be because of embarrassment or it could be because it may not be understood that IBD affects far more parts of the body than just the gastrointestinal tract. 


I Lost Control of My Bowels

Man Running To Toilet

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Having a bathroom accident is arguably the most difficult thing you will ever need to admit to your healthcare providers. It seems to most of us that having an accident or being incontinent is just too personal to talk about and that it should be kept private. The problem is, though, that if you don't tell anyone that it happened, no one can help you.

If you are losing control, that means that something is not going well with your treatment, and it may be time for a change. Maybe it's your only symptom right now, and you feel fine except that you couldn't make it to the toilet on time. Or maybe you're already flaring and this is one more upsetting sign of your IBD that you need to manage.

In any case, you must tell your healthcare providers. You can try rehearsing the words in the mirror before you must say them to someone. You could write it in a letter and hand it to your doc or send it in before your appointment. You must do whatever is necessary to get the words out and get the issue on the table.

Your practitioner has heard this before from patients with IBD, and it's not going to shock them. Instead, you can both treat this information like any other sign or symptom and move towards finding out to address the problem. 


My Sex Life Isn't What I Want It to Be

Happy Couple eating breakfast

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For those with a chronic illness like IBD, the idea of a healthy sex life may seem not only far off, but also a topic that's not even worth mentioning to healthcare providers. That could not be further from the truth. If your intimate life with your partner is not satisfying, you should talk to your practitioner about the problem.

Everyone deserves the sex life that they and their partner want to have together. IBD provides a lot of barriers to enjoying intimacy, but there are ways those problems can be mitigated. There are treatments that can help you enjoy sex with your partner again.

Your healthcare provider can help you determine what the problems are and figure out if you need another healthcare provider to assist with your specific concerns. But you can't get started on solving the problem unless you start the conversation. You can't wait for your practitioners to ask about this one – you need to bring it up yourself. 


My Joints Hurt

doctor talking to patient in office

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Why would you ever mention your aches and pains to your gastroenterologist? That's not something that's related to IBD, right? Wrong! Approximately 25% of people who have IBD also have related joint pain or one of several different forms of arthritis. Arthritis in people with IBD may need to be treated differently than arthritis in people who don't have any other related conditions.

This is a condition that may require a referral to another specialist, but your IBD doctor should remain involved and both conditions need to be treated while keeping the other in mind. This is one situation where you will want to make sure your healthcare providers are talking with each other about your care, and that everyone is aware of what's going on with your treatment. 


My Eyes Are Bothering Me

doctor conducting Eye Exam

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How can your digestive disease have anything to do with your eyes? It may seem that one might not have anything to do with another, but people with IBD may also develop various eye conditions, either related to IBD or as a result of certain treatments. Uveitis, glaucomaepiscleritis, and cataracts are all eye conditions that may be related to IBD or to the treatments for IBD.

These are not conditions that can be ignored because they can threaten your sight permanently. You may already be seeing an eye specialist, but your gastroenterologist should also know about any problems you are having with your eyes.

Because of the potential for eye problems, every person who has IBD should be seeing an optometrist or an ophthalmologist on a regular basis – yearly if possible. If any eye problems do develop, your gastroenterologist needs to know about them. 


I'm Not Sleeping

woman staring at clock experiencing Insomnia

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People who have IBD know that they don't get enough quality sleep. It may also be a sign of IBD that is glossed over because doesn't everyone know that a person who is sick doesn't sleep well? Yet you can't let anything be unspoken when it comes to your health, and if your healthcare providers aren't asking you about sleep, then you need to be asking them.

Sleep can have a profound effect on IBD, and the research is just starting to uncover exactly why and how that happens. There is plenty of at-home care that can be done to help with sleep, but there are also treatments available.

Furthermore, a sleep schedule that is not supportive of health could be another sign that IBD is not being managed effectively. In fact, there is some evidence that sleep disturbances may show up before other signs of IBD do.


I Have Problems With My Skin

dermatologist conducting Skin Exam

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A lot of people get rashes from time to time and don't think too much about it. A new soap or detergent could lead to some skin irritation, and most people will just ignore those small problems. However, people with IBD are at risk for skin problems that are more serious than a little irritation from a change of soap.

Pyoderma gangrenosum, aphthous ulcers, and erythema nodosum are skin conditions that are related to IBD. Erythema nodosum are lesions that occur mainly on the arms and legs. Pyoderma gangrenosum may start as a small cut or abrasion but turns into an ulcer. Aphthous stomatitis (recognize that word "stoma?" – it means "mouth") are ulcers that occur inside the mouth. 

This photo contains content that some people may find graphic or disturbing.

erythema nodosum on legs
Erythema nodosum.

DermNet / CC BY-NC-ND

This photo contains content that some people may find graphic or disturbing.

pyoderma gangrenosum on ankle
Pyoderma gangrenosum.

DermNet / CC BY-NC-ND

This photo contains content that some people may find graphic or disturbing.

aphthous ulcer
Aphthous ulcer.

DermNet / CC BY-NC-ND

In some cases, these skin disorders can be not much more than an annoyance, but in others, they can be quite serious and may need treatment. Getting IBD under control may also help with these conditions, but even if the IBD is in remission, you should always mention anything unusual with your skin to your healthcare providers, and have it looked at promptly.

6 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. National Institute of Diabetes and Digestive and Kidney Diseases. Bowel Control Problems (Fecal Incontinence).

  2. Rosenblatt E, Kane S. Sex-Specific Issues in Inflammatory Bowel DiseaseGastroenterol Hepatol (N Y). 2015;11(9):592–601.

  3. Arvikar SL, Fisher MC. Inflammatory bowel disease associated arthropathyCurr Rev Musculoskelet Med. 2011;4(3):123–131. doi:10.1007/s12178-011-9085-8

  4. Troncoso LL, Biancardi AL, de Moraes HV Jr, Zaltman C. Ophthalmic manifestations in patients with inflammatory bowel disease: A reviewWorld J Gastroenterol. 2017;23(32):5836–5848. doi:10.3748/wjg.v23.i32.5836

  5. Swanson GR, Burgess HJ. Sleep and Circadian Hygiene and Inflammatory Bowel Disease. Gastroenterol Clin North Am. 2017;46(4):881-893. doi:10.1016/j.gtc.2017.08.014

  6. Huang BL, Chandra S, Shih DQ. Skin manifestations of inflammatory bowel diseaseFront Physiol. 2012;3:13. doi:10.3389/fphys.2012.00013

By Amber J. Tresca
Amber J. Tresca is a freelance writer and speaker who covers digestive conditions, including IBD. She was diagnosed with ulcerative colitis at age 16.