Are patients in the IBD clinic at risk of proctitis secondary to sexually transmitted infections?

Objective: To gauge the potential risk of sexually transmitted infection (STI) as a cause of proctitis in a cohort of patients with inflammatory bowel disease (IBD) and to gauge whether this cohort could benefit from STI testing in the future.Design: Patients attending the IBD clinic were given an anonymous questionnaire recording demographics, sexual behaviour, rectal symptoms, history of receptive anal intercourse (RAI), STIs and attitudes towards sexual health screening.Setting: A gastroenterology teaching hospital IBD clinic.Patients: 280 consecutive patients attending a teaching hospital IBD clinic over a consecutive 6-week period. All patients had an endoscopic, radiological and/or histological diagnosis of IBD.Results: 280 questionnaires were distributed and 274 analysed (3 incomplete, 2 not returned, 1 no sexual activity). 167 female (median: 46 years, range 17-81 years) and 107 males. Two males disclosed RAI and were used as a control. Of the 167 females, 96% were heterosexual, 2.4% were same-sex partners and 1.2% were bisexual. 14% had a history of RAI-this group had more previous STIs (40%) versus those with no history RAI (5%) (p<0.0001; relative risk (RR) 13.41). Chronic rectal pain was more frequent in women with RAI (RR 2.4; p≤0.03). No difference in rectal discharge (RR 1.75; p=0.72) or bleeding (p=0.3).Conclusions: This is the first report of sexual behaviours in a non-genitourinary medicine clinic; giving a unique insight into sexual practices in a cohort of patients with IBD. A past history of STI and RAI can identify risk and we propose testing for those with a history of STI, RAI, men who have sex with men and women aged under 25 years.