By Alexa Federico, as told to Lisa Mulcahy.
I’m 27, live in Boston, and am a certified nutritional therapist, an AIP coach, an author, and the owner of my own business, Alexa Federico Wellness. And I have Crohn’s disease.
I was 12 when I was diagnosed. Many of my close friends have only known me since I had Crohn’s disease. They’ve seen me sick, so I’ve been lucky that I didn’t have to do much to tell them about it. Those friends have always been so helpful and supportive.
A few years ago I developed complications: three fistulas and an abscess. I had antibiotics and a drain for 6 weeks, but it turned out I needed surgery, so I had a bowel resection in 2019.
Dating experiences that I thought were going to be difficult. I have experienced major insecurities about my body. I started to feel damaged, which wasn’t fun. The intestinal resection left me with a scar on my abdomen. So I was really worried about intimacy: what would happen if a man saw it? But then I realized I had to change my attitude. I simply decided that the way to deal with the scar and all the other concerns about relationships and Crohn’s disease was with total honesty.
When I started meeting new guys, I quickly realized that it was better to tell them sooner or later that I had Crohn’s disease. Holding the information felt like a burden, so the sooner I let it go, the better I felt. My previous experiences with supportive friends made me think: Okay, I’ll just say that I got this scar after my surgery, here it is, you can see it. And no one ever rolled their eyes!
That gave me much more confidence. I decided that within one to two dates I would tell guys I really liked them. By the third date, I feel like you know enough about the person you’re with to decide if you want to continue the relationship. Crohn’s disease is part of me, so of course I’m going to talk about it.
When a man I was seeing asked about the scar, I explained the intestinal surgery, how I had an infection and that the doctors had to remove some parts of my intestine. I also mentioned that it was a great decision for my health. He was genuinely interested and understanding. I never tried to cover it up or show my insecurity about it. I think not making a big deal about it helps!
For women who are intimidated by dating and intimacy because of their Crohn’s disease, make sure you are with someone you feel safe with and trust. That is the most important. Then be open. Intimacy isn’t scary if you don’t feel like you have to hide anything. Let your partner know what your concerns are. If you do this in advance and something happens at that moment that you think is embarrassing, you have already talked about it.
I have never had a man who did not accept me by talking about my diagnosis. If I ever got a bad response, I would simply not continue with that person. I believe in romance AND respect – a man would want to learn how to support me, just as I want to learn how to support him. If it isn’t there, I can’t be there. I have learned to communicate clearly. With my relationships I put it all on the table. I want a man who doesn’t run away from conflict. I have worked a lot on myself and I want someone who is strong.
I dated a man who wasn’t the person he imagined. He was a lot older than I thought, and that didn’t bother me as much as the fact that he wasn’t honest about it. He tried to look younger. And my stomach dropped. I just thought, if you mess this up, what else are you going to do? This isn’t the kind of relationship I want.
You have to be very diligent about ending a date within an hour if you think this person won’t be right for you. For myself? Ultimately, I want a positive relationship where I get what I need and give it back. THAT is romantic. I deserve that kind of love — and whether you have Crohn’s disease or not, so do you.
Alexa’s commitment to honesty is the foundation of the right approach to intimacy and Crohn’s disease. “In terms of romantic relationships, it all starts with good communication,” says Megan Elizabeth Riehl, PsyD, clinical assistant professor of psychology at the University of Michigan Medical School in Ann Arbor. “You want to go in with the goal of initially sharing what you feel comfortable sharing. See how this person responds to you. If you have Crohn’s disease, there may be times when you go on a date and are stuck in the bathroom for a long time. How does your date behave in that situation? Is this a nice person? Does this person show you that he or she deserves to be in your life?
That’s the key: never let Crohn’s make you feel like you have to settle. “Ask yourself: Do you enjoy being with this person while you talk more deeply?” says Riehl. “Your Crohn’s diagnosis is just part of who you are as a person. You want to have fun with the person you are with. You want to have the same interests.”
You also don’t have to worry about limitations in relationships. “Many of my patients with IBS express long-term concerns – for example, can they have a healthy child? IBS sufferers can do this, and it’s important to talk to your doctor and your partner about this. Short-term work with a mental health professional can also be helpful in developing skills for discussing personal goals if you have Crohn’s disease.
Ultimately, talking openly about the condition can help you build a strong bond. “The truth in a relationship is like peeling an onion: you peel back the layers, reveal yourself and relax into it,” Riehl summarizes. “With Crohn’s disease, you can help your partner understand by being honest about what you’re going through.”