Men who have sex with men are at a higher risk for inflammatory bowel disease (IBD), finds a new study. Case Western Reserve University researchers say the risk of IBD more than doubles in homosexual versus heterosexual men when engaging in high-risk sexual activity.
For this study, high-risk sexual activity was considered sexual contact without protection and having multiple sexual partners.
“To our knowledge, this is the first large population-based study that demonstrates a higher prevalence of IBD in men who engage in high-risk same-sex sexual activity,” says Emad Mansoor, an assistant professor at the Case Western Reserve School of Medicine and University Hospitals Cleveland Medical Center and lead study author, in a statement. “Our study is expected to open a new field of research into gastrointestinal inflammatory conditions.”
The cause of IBD is poorly understood, and more so in men who have sex with men. According to Gallup, over 7.1% of the United States population identifies as LGBTQIA+, up from the 5.6% recorded in 2020. Fabio Cominelli, a professor at the School of Medicine and chief scientific officer at University Hospitals, says that understanding the cause of disease development in Crohn’s disease and ulcerative colitis will help create a personalized treatment plan, while also reducing the stigma behind these conditions.
The researchers analyzed self-reported data from 58 U.S. healthcare organizations between 2002 and 2022. Of the people who engaged in high-risk same-sex sexual activity, 0.8% also had Crohn’s disease, and 1.26% had ulcerative colitis. The risk for both diseases was higher than for men who had sex with women. In high-risk heterosexual activity, 0.49% of men had Crohn’s disease, and 0.52% had ulcerative colitis.
Researchers also looked at additional associations with high-risk same-sex sexual activity related to Crohn’s disease. Sexually active gay men had a greater chance of having peri-anal disease, including peri-anal abscess, rectal abscess, and stricturing disease of the colon or small intestine. Moreover, among men with severe ulcerative colitis, they found men in high-risk same-sex sexual activity were more likely to require partial colectomy.
The team will use the current study findings as part of a large-scale study on how the gut microbiome affects the risk of gastrointestinal disorders among LBGTQIA+ individuals. “We are in the process of opening a new clinic dedicated to LGBTQ+ patients with the goal of improving access to healthcare,” notes Cominelli. “Our goal is to improve patient access and develop new therapies for gastrointestinal conditions.”
The study is published in the journal Gut.