Love and Dating With Ulcerative Colitis

Dating can be stressful for anyone. But when you have ulcerative colitis (UC), you might be more anxious than usual about starting a relationship.

“People feel concerned about whether their partner can support them during their disease, but also whether people will still find them attractive or want to continue dating them once they’ve learned about the disease,” says Madison Simons, PsyD, a gastrointestinal psychologist at Cleveland Clinic in Ohio.

Dr. Simons stresses that people with UC can have very satisfying and fulfilling relationships. Keep in mind, though, that your feelings and body image may change depending on whether the disease is active or in remission. And during a flare, your priorities may have to change, too.

“When the disease is active, that’s a time to focus on treating it,” Simons says. It’s okay to table the bigger decisions about dating and family planning until you’re in remission. “When you’re not flaring, [you’ll] be able to think about these things in ways that are more in line with [your] values,” she says.

Here are a few common relationship concerns for people with UC, as well as tips for coping with each.

Natalie Kelley, 25, a chronic illness mindset coach, blogger, and podcaster, was diagnosed with ulcerative colitis at age 21, in 2017, and met her current girlfriend in August 2021 through a dating app. Kelley says that while she didn’t feel worried about her symptoms, she did feel pressure about being able to “do enough” or be “fun enough” when she was first diagnosed with UC. “I was concerned that people would get frustrated by my body’s limits,” she says.

It’s helpful for people who are entering into relationships to keep the long-term trajectory in mind and remember that many people with UC have partners who are very supportive of the condition. “It’s much more difficult in the beginning, and body image concerns reduce over time,” Simons says.

Remember, too, that if a person has a negative reaction to symptoms and limitations you have, that’s a reflection on them, not on you. “It simply shows they aren’t the right fit for you,” says Kelley.

On the first few dates with someone new, you may stress because you’re worried you’ll have to use the bathroom frequently or urgently.

Kelley recommends picnic dates in public parks. “There are typically restrooms accessible, and you can bring your own snacks to share that you know are safe for you to eat,” she says.

Kelley used to worry about activities like long hikes. “The fear of the ‘what-ifs’ — What if there’s no bathroom? What if halfway up, my UC acts up and we have to turn around? — would take over,” she says. Being open about these concerns with the person before the date makes it easier to discuss any issues that do arise during the date. “It eased a lot of the anxiety, knowing they were already in the loop,” says Kelley.

Finally, try to remind yourself that you may have more bowel movements, and that’s okay. “The more we try to fight the symptoms, the more they tend to become severe,” says Simons.

There is not a “right” time to disclose that you have UC, although Simons says earlier is usually better. “In general, we find people are more satisfied when they’re able to talk about what’s going on for them, even if it doesn’t mean sharing all of the details,” she says.

“I always lived by the motto that telling folks sooner rather than later was always better,” says Kelley. “Telling a potential partner on the first or second date allows you to gauge if they’re worth your continued energy.”

When you are ready to talk, remember that not everyone is familiar with UC. Start by giving your partner the basics. You could say, “It’s a lifelong condition that causes inflammation and sores in the large intestine and rectum,” or alternatively, “It’s a chronic inflammatory bowel disease.” Then focus on what UC is like for you and how they can help — for example, knowing there’s a bathroom readily available in case your symptoms are flaring.

“Your partner isn’t going to know what you need unless you tell them, so they really benefit from knowing what that experience is like for you and what you found helpful in coping with it,” says Simons.

It’s also a good idea to save this conversation for when your disease is in remission, Simons adds, since you may feel more stable then and more confident in your ability to communicate with the other person.

“Open communication has been the most helpful aspect in my relationship, because I don’t feel any anxiety around sharing my needs and asking for support from my partner,” says Kelley.

Keep in mind that while it’s important to be with a partner who is supportive of you and the condition, they don’t necessarily have to be your go-to support person. You might prefer to find someone else who can support you with your symptoms, such as a mental health therapist, a friend with UC, or a support group for people with gastrointestinal issues.

“You may not have to depend so much on your partner to understand all the details of your day-to-day experience,” she says. “If someone hasn’t had bowel concerns, they may not understand what it’s like for you to have that amount of pain or fear with bowel movements. Recognize that a person can still love and support you very much without personally understanding what that’s like.”

When you first move in with a partner, you may worry about sharing a bathroom 24/7, particularly if you have active disease and need to use the toilet many times per day. Simons says this is an area where open communication can be particularly helpful.

She suggests talking to your partner about what you need to have in the bathroom to make it comfortable for you, such as wipes. Simons also recommends describing what it’s like when you have urgency and can’t wait. “Your partner may not understand that unless you explain it to them,” she says.

Kelley says she plans to move in with her partner soon. “I truly have no embarrassment around my illness and know no matter what, everything with my UC will be totally okay while living with her,” she says. “But if you do have fears or issues around moving in with a partner while living with UC, making sure you sit down and talk about those fears and the solutions — before moving in together — is crucial.”

As with other parts of your relationship, having open communication is key, Simons says, and it’s a good idea to first approach the topic when you’re in remission. “Sexual interest and body image go along with how active the disease is,” she says.

When you are ready for sex, the key is to accept the condition and plan ahead, Simons says. Recognize that you may have symptoms, and try to plan for how you’ll cope if they occur. For example, how will you prepare your partner to see your ostomy pouch for the first time? What would you do to feel confident if you have bowel leakage?

Talking these things through with a mental health professional or support group can be a good place to start. Ask how others have handled specific concerns. “The more we can accept the symptoms, as uncomfortable as they might be, the more we feel competent when dealing with them,” says Simons.

And if symptoms cause discomfort during an encounter, be honest instead of trying to push past those feelings. “Remind yourself that it’s your body, and you can stop intimacy whenever you want,” says Kelley. “Simply letting your partner know you may sometimes have to pause intimacy is helpful.”

Kelley adds that a partner can be emotionally supportive during appointments or even just give you affirmation. When they do, focus on gratitude. “It’s so easy to feel like a burden while living with UC,” says Kelley. “Instead of feeling guilty, replace those thoughts with I’m so thankful I have a supportive partner.”

And if you’re only hesitant about having kids because of the risk of passing IBD on to them, know that no parent can guarantee their child won’t become sick. Even if your child does have IBD, Simons suggests reframing that thought as Who better to help them cope with this than me, because I’ve been through it before and I know how to support them?

The Takeaway

• Dating can be stressful for people with UC, especially at the start of a new relationship, but remember that body image concerns can subside over time.
• Try going for a date in a public park — there are usually restrooms available and you can bring your own snacks.
• Figure out your "chronic illness elevator pitch" — a short summary of your condition and your journey.