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Association between bowel movement frequency and erectile dysfunction in patients with ulcerative colitis: a cross-sectional study

International Journal of Impotence Research (2024)Cite this article

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Abstract

The association between ulcerative colitis (UC) and erectile dysfunction (ED) has been previously reported. Numerous previous studies have also reported an association between gastrointestinal symptoms and ED. Constipation and diarrhea are common in patients with UC. However, the specific association between bowel movement frequency and ED remains unclear. The aim of this study is to investigate the association between bowel movement frequency and ED in 164 patients with UC. The definition of ED, moderate to severe ED, and severe ED was the Sexual Health Inventory for Men score <22, <12, and <8, respectively. Bowel movement frequency was divided into three categories: (1) high (More than once a day), (2) normal (once a day, reference), and low (less than one time/day). The definition of constipation was based on the Rome I criteria and/or medication for constipation. The prevalence of constipation and ED was 10.4% and 86.0%, respectively. The rate of high, normal, and low bowel movement frequency was 56.1%, 25.0%, and 18.9%, respectively. High bowel movement frequency was independently and positively associated with ED and moderate to severe ED (ED: adjusted odds ratio [OR] 4.42, 95% confidence interval [CI] 1.35–15.98; moderate to severe: adjusted OR 2.98, 95% CI 1.22–7.61). Low bowel movement frequency was independently and positively associated with moderate to severe ED and severe ED (moderate to severe: adjusted OR 3.96, 95% CI 1.27–13.08; severe: adjusted OR 3.20, 95% CI 1.08–9.86). No association between constipation and ED was found. In conclusion, in Japanese patients with UC, both high and low bowel movement frequency were independently and positively associated with ED.

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The datasets used and/or analyzed in the current study are available from the corresponding author on reasonable request.

References

  1. Kobayashi T, Siegmund B, Le Berre C, Wei SC, Ferrante M, Shen B, et al. Ulcerative colitis. Nat Rev Dis Primers. 2020;6:74. https://doi.org/10.1038/s41572-020-0205-x

    Article  PubMed  Google Scholar 

  2. Ng SC, Shi HY, Hamidi N, Underwood FE, Tang W, Benchimol E, et al. Worldwide incidence and prevalence of inflammatory bowel disease in the 21st century: a systematic review of population-based studies. Lancet. 2017;390:2769–78. https://doi.org/10.1016/S0140-6736(17)32448-0

    Article  PubMed  Google Scholar 

  3. Salonia A, Bettocchi C, Boeri L, Capogrosso P, Carvalho J, Cilesiz NC, et al. European Association of Urology Guidelines on Sexual and Reproductive Health-2021 Update: male sexual dysfunction. Eur Urol. 2021;80:333–57. https://doi.org/10.1016/j.eururo.2021.06.007

    Article  PubMed  Google Scholar 

  4. Friedman S, Magnussen B, OʼToole A, Fedder J, Larsen MD, Nørgård BM. Increased use of medications for erectile dysfunction in men with ulcerative colitis and Crohn’s disease compared to men without inflammatory bowel disease: a nationwide cohort study. Am J Gastroenterol. 2018;113:1355. https://doi.org/10.1038/s41395-018-0177-6

    Article  CAS  PubMed  Google Scholar 

  5. Kao CC, Lin CL, Huang WY, Cha TL, Lin TY, Shen CH, et al. Association between inflammatory bowel disease and erectile dysfunction: a nationwide population-based study. Inflamm Bowel Dis. 2016;22:1065–70. https://doi.org/10.1097/MIB.0000000000000695

    Article  PubMed  Google Scholar 

  6. Kaya-Sezginer E, Gur S. The inflammation network in the pathogenesis of erectile dysfunction: attractive potential therapeutic targets. Curr Pharm Des. 2020;26:3955–72. https://doi.org/10.2174/1381612826666200424161018

    Article  CAS  PubMed  Google Scholar 

  7. Chang JT. Pathophysiology of inflammatory bowel diseases. N Engl J Med. 2020;383:2652–64. https://doi.org/10.1056/NEJMra2002697

    Article  CAS  PubMed  Google Scholar 

  8. Chao CH, Lin CL, Wang HY, Sung FC, Chang YJ, Kao CH. Increased subsequent risk of erectile dysfunction in patients with irritable bowel syndrome: a nationwide population-based cohort study. Andrology. 2013;1:793–8. https://doi.org/10.1111/j.2047-2927.2013.00120.x

    Article  PubMed  Google Scholar 

  9. Gwee KA, Siah KT, Wong RK, Wee S, Wong ML, Png DJ. Prevalence of disturbed bowel functions and its association with disturbed bladder and sexual functions in the male population. J Gastroenterol Hepatol. 2012;27:1738–44. https://doi.org/10.1111/j.1440-1746.2012.07243.x

    Article  PubMed  Google Scholar 

  10. James SL, van Langenberg DR, Taylor KM, Gibson PR. Characterization of ulcerative colitis-associated constipation syndrome (proximal constipation). JGH Open. 2018;2:217–22. https://doi.org/10.1002/jgh3.12076

    Article  PubMed  PubMed Central  Google Scholar 

  11. Yang S, Yu C, Guo Y, Bian Z, Fan M, Yang L, et al. Bowel movement frequency and risks of major vascular and non-vascular diseases: a population-based cohort study among Chinese adults. BMJ Open. 2020;10:e031028. https://doi.org/10.1136/bmjopen-2019-031028

    Article  PubMed  PubMed Central  Google Scholar 

  12. Whitehead WE, Chaussade S, Corazziari E, Kumar D. Report of an international workshop on management of constipation. Gastroenterol Int. 1991;4:99–113.

    Google Scholar 

  13. Rosen RC, Cappelleri JC, Smith MD, Lipsky J, Peña BM. Development and evaluation of an abridged, 5-item version of the International Index of Erectile Function (IIEF-5) as a diagnostic tool for erectile dysfunction. Int J Impot Res. 1999;11:319–26. https://doi.org/10.1038/sj.ijir.3900472

    Article  CAS  PubMed  Google Scholar 

  14. Ma S, Veysey M, Ersser S, Mason-Jones A, Galdas P. The impact of inflammatory bowel disease on sexual health in men: a scoping review. J Clin Nurs. 2020;19:3638–51. https://doi.org/10.1111/jocn.15418

    Article  Google Scholar 

  15. Shmidt E, Suárez-Fariñas M, Mallette M, Moniz H, Bright R, Shah SA, et al. Erectile dysfunction is highly prevalent in men with newly diagnosed inflammatory bowel disease. Inflamm Bowel Dis. 2019;25:1408–16. https://doi.org/10.1093/ibd/izy401

    Article  CAS  PubMed  Google Scholar 

  16. Zhang J, Nie J, Zou M, Zeng Q, Feng Y, Luo Z, et al. Prevalence and associated factors of sexual dysfunction in patients with inflammatory bowel disease. Front Endocrinol. 2022;13:881485 https://doi.org/10.3389/fendo.2022.881485

    Article  Google Scholar 

  17. Furukawa S, Takeshita E, Miyake T, Tange K, Tomida H, Yamamoto Y, et al. Disease activity and erectile dysfunction in Japanese patients with ulcerative colitis. Sex Med. 2023;11:qfad024 https://doi.org/10.1093/sexmed/qfad024

    Article  PubMed  PubMed Central  Google Scholar 

  18. Rivière P, Zallot C, Desobry P, Sabaté JM, Vergniol J, Zerbib F, et al. Frequency of and factors associated with sexual dysfunction in patients with inflammatory bowel disease. J Crohns Colitis. 2017;11:1347–52. https://doi.org/10.1093/ecco-jcc/jjx100

    Article  PubMed  Google Scholar 

  19. García-Cabo C, Morís G. Peripheral neuropathy: an underreported neurologic manifestation of inflammatory bowel disease. Eur J Intern Med. 2015;26:468–75. https://doi.org/10.1016/j.ejim.2015.07.013

    Article  PubMed  Google Scholar 

  20. Gondim Fde A, de Oliveira GR, Teles BC, Aquino Pde S, Brasil ÉF, Carvalho AM, et al. Clinical and electrodiagnostic findings in patients with peripheral neuropathy and inflammatory bowel disease. Inflamm Bowel Dis. 2015;21:2123–9. https://doi.org/10.1097/MIB.0000000000000459

    Article  PubMed  Google Scholar 

  21. Chen Z, Li G, Liu J. Autonomic dysfunction in Parkinson’s disease: implications for pathophysiology, diagnosis, and treatment. Neurobiol Dis. 2020;134:104700 https://doi.org/10.1016/j.nbd.2019.104700

    Article  PubMed  Google Scholar 

  22. Nishihara Y, Ogino H, Tanaka M, Ihara E, Furukawa K, Nishioka K, et al. Mucosa-associated gut microbiota reflects clinical course of ulcerative colitis. Sci Rep. 2021;11:13743 https://doi.org/10.1038/s41598-021-92870-0

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  23. Anselmi G, Gagliardi L, Egidi G, Leone S, Gasbarrini A, Miggiano GAD, et al. Gut microbiota and cardiovascular diseases: a critical review. Cardiol Rev. 2021;29:195–204. https://doi.org/10.1097/CRD.0000000000000327

    Article  PubMed  Google Scholar 

  24. Okamoto T, Hatakeyama S, Imai A, Yamamoto H, Yoneyama T, Mori K, et al. The association between gut microbiome and erectile dysfunction: a community-based cross-sectional study in Japan. Int Urol Nephrol. 2020;52:1421–8. https://doi.org/10.1007/s11255-020-02443-9

    Article  CAS  PubMed  Google Scholar 

  25. Li Y, Xia S, Jiang X, Feng C, Gong S, Ma J, et al. Gut microbiota and diarrhea: an updated review. Front Cell Infect Microbiol. 2021;11:625210 https://doi.org/10.3389/fcimb.2021.625210

    Article  PubMed  PubMed Central  Google Scholar 

  26. Furukawa S, Sakai T, Niiya T, Miyaoka H, Miyake T, Yamamoto S, et al. Depressive symptoms and prevalence of erectile dysfunction in Japanese patients with type 2 diabetes mellitus: the Dogo Study. Int J Impot Res. 2017;29:57–60. https://doi.org/10.1038/ijir.2016.45

    Article  CAS  PubMed  Google Scholar 

  27. Matsuoka K, Igarashi A, Sato N, Isono Y, Gouda M, Iwasaki K, et al. Trends in corticosteroid prescriptions for ulcerative colitis and factors associated with long-term corticosteroid use: analysis using Japanese claims data from 2006 to 2016. J Crohns Colitis. 2021;15:358–66. https://doi.org/10.1093/ecco-jcc/jjaa1

    Article  PubMed  Google Scholar 

Download references

Acknowledgements

The authors would like to thank Kenichiro Mori, Keitarou Kawasaki, Yuji Mizukami, Satoshi Imamine, Masamoto Torisu, Harumi Yano, Makoto Yano, Masato Murakami, Aki Hasebe, Masumi Hino, and Tomo Kogama.

Funding

This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.

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Authors and Affiliations

  1. Health Services Center, Ehime University, Matsuyama, Ehime, 790-8577, Japan

    Shinya Furukawa

  2. Department of Gastroenterology and Metabology, Ehime University Graduate School of Medicine, Toon, Ehime, 791-0295, Japan

    Teruki Miyake, Osamu Yoshida, Yu Hashimoto & Yoichi Hiasa

  3. Department of Gastroenterology, Matsuyama Shimin Hospital, Matsuyama, Ehime, 790-0067, Japan

    Masakazu Hanayama

  4. Department of Gastroenterology, Ehime Prefectural Central Hospital, Matsuyama, Ehime, 790-0024, Japan

    Shogo Kitahata & Tomoyuki Ninomiya

  5. Department of Internal Medicine, Saiseikai Imabari Hospital, Matsuyama, Ehime, 799-1592, Japan

    Sen Yagi

  6. Department of Gastroenterology, Sumitomo Besshi Hospital, Niihama, Ehime, 792-8543, Japan

    Seiyuu Suzuki

  7. Department of Gastroenterology, Ehime Prefectural Niihama Hospital, Niihama, Ehime, 792-0042, Japan

    Naozumi Shibata

  8. Department of Internal Medicine, Saiseikai Matsuyama Hospital, Matsuyama, Ehime, 791-8026, Japan

    Hidehiro Murakami & Kana Shiraishi

  9. OHASHI Clinic participate in Gastro-Enterology and Ano-Proctology, Niihama, Ehime, 792-0856, Japan

    Katsuhisa Ohashi

  10. Department of Inflammatory Bowel Diseases and Therapeutics, Ehime University Graduate School of Medicine, Toon, Ehime, 791-0295, Japan

    Kazuhiro Tange & Eiji Takeshita

  11. Endoscopy Center, Ehime University Hospital, Toon, Ehime, 791-0295, Japan

    Hideomi Tomida, Yasunori Yamamoto & Yoshio Ikeda

Authors
  1. Shinya Furukawa
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  2. Teruki Miyake
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Contributions

Conceptualization: Shinya Furukawa, Yoichi Hiasa, Eiji Takeshita, and Yoshio Ikeda. Data curation: Teruki Miyake, Osamu Yoshida, Masakazu Hanayama, Shogo Kitahata, Tomoyuki Ninomiya, Sen Yagi, Seiyuu Suzuki, Naozumi Shibata, Hidehiro Murakami, Katsuhisa Ohashi, Kana Shiraishi, Kazuhiro Tange, Yu Hashimoto, Hideomi Tomida, Yasunori Yamamoto, Eiji Takeshita, and Yoshio Ikeda. Investigation: Kana Shiraishi, Kazuhiro Tange, Yu Hashimoto, Sen Yagi, Shogo Kitahata, Tomoyuki Ninomiya, Masakazu Hanayama, Seiyuu Suzuki, Naozumi Shibata, Hidehiro Murakami, Katsuhisa Ohashi, Hideomi Tomida, Yasunori Yamamoto, Eiji Takeshita, and Yoshio Ikeda. Formal analysis: Shinya Furukawa. Software: Shinya Furukawa. Supervision: Yoichi Hiasa. Writing: Shinya Furukawa, Teruki Miyake, Osamu Yoshida. All authors have contributed significantly. All the authors have approved the manuscript and agree with submission to your esteemed journal.

Corresponding author

Correspondence to Shinya Furukawa.

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The authors declare no competing interests.

Ethical approval

All patients in this study were informed about the study by well-trained staff and gave written informed consent. The study protocol was prepared in accordance with the 1964 Declaration of Helsinki and subsequent ethical guidelines and was approved by the Ethics Committee of Ehime University School of Medicine (approval number 1505011). This study is also registered UMIN Clinical Trials Registry (000051334).

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Furukawa, S., Miyake, T., Yoshida, O. et al. Association between bowel movement frequency and erectile dysfunction in patients with ulcerative colitis: a cross-sectional study. Int J Impot Res (2024). https://doi.org/10.1038/s41443-024-00884-9

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