Could Celiac Disease be Affecting Your Sex Life?

‘Partner Burden’ has been identified as having a negative impact on relationships with more than one-third of partners experiencing poorer sexual and relationship satisfaction. In an overview of topics covered at Digestive Disease Week 2016, a national meeting for gastroenterologists held in San Diego, California, Dr. David A. Johnson(1) related:

“One of the interesting abstracts that was presented from a group at Columbia University in New York looked at the care burden for the spouse or partner of whomever had sustained illness. They looked at 94 patient-partner pairs, with the patients having celiac disease. They found that there was a sizeable percentage of partners who had had really poor quality of life and poor sexual satisfaction.”

“Something that I think we need to do a better job of is looking at the impact of disease on family life and diseases that partners or spouses may have. Partner burden certainly increases the likelihood that these people without the disease may be having ongoing problems.”

Partner Burden: A Common Entity in Celiac Disease. (2)

BACKGROUND
Caregiver burden is documented in several chronic diseases, but it has not been investigated in celiac disease (CD).

AIMS
We aim to quantify the burden to partners of CD patients and identify factors that affect the perceived burden.

METHODS:
94 patients with biopsy-proven CD and their partners completed CD-specific questions, including the validated Celiac Symptom Index (CSI) survey. Partners also completed the validated Zarit Burden Interview (ZBI) and questions regarding sexual and relationship satisfaction.

RESULTS

Fifteen patients (16 %) reported a CSI score associated with a poor quality of life, and 34 partners (37 %) reported a ZBI score corresponding to mild-to-moderate burden.

Twenty-two partners (23 %) reported moderate-to-low overall relationship satisfaction, and 12 (14 %) reported moderate-to-low sexual satisfaction.

The degree of partner burden was directly correlated with patient CSI score (r = 0.27; p = 0.008), and there were moderate-to-strong inverse relationships between partners’ burden and relationship quality (r = -0.70; p < 0.001) and sexual satisfaction (r = -0.42; p < 0.001).

On multivariable logistic regression, predictors of mild-to-moderate partner burden were low partner relationship satisfaction (OR 17.06, 95 % CI 2.88-101.09, p = 0.002) and relationship duration ≥10 years (OR 14.42, 95 % CI 1.69-123.84, p = 0.02).

CONCLUSIONS
Partner burden is common in CD, with more than one-third of partners experiencing mild-to-moderate burden. Partner burden is directly correlated with patient symptom severity, and it increases with poorer sexual and relationship satisfaction. Healthcare providers should address relationship factors in their care of patients with CD.