P317 Patient satisfaction in a joint fistula clinic at a tertiary Inflammatory Bowel Disease centre in the United Kingdom

Mukhtar, M.S.H.(1)*;Lim, W.J.(2);Tozer, P.(3);Hart , A.(2);

(1)St. Mark’s Hospital and National Bowel Center, Gastroenterology- IBD Unit, London, United Kingdom;(2)St. Mark's Hospital and National Bowel Centre, Gastroenterology- IBD Unit, London, United Kingdom;(3)St. Mark's Hospital and National Bowel Centre, Department of Colorectal Surgery, London, United Kingdom;


Patients with fistulising perianal Crohn’s disease experience significant impairments in their sexual and social relationships, work, and overall life quality. The presence of perianal disease can result in patients avoiding sex, ending intimate relationships, and feeling inadequate or guilty towards their partners. Some participants also report partners’ refusal to engage in sex(1).
Access to joint fistula clinics, where patients can simultaneously meet gastroenterologists and surgeons, may yield better care. However, sharing intimate details about the sexual-, social-, and mental-health effects of fistulising disease can be particularly difficult and anxiety-provoking for patients, when there are multiple healthcare workers present.


An evaluation questionnaire was developed to assess patients’ overall perception and satisfaction regarding the joint fistula clinic at St. Mark’s Hospital in London. All patients who attended in person and were able to understand English and provide verbal consent were invited to provide their feedback. The questionnaire included items assessing overall comfort, ease of discussing intimate social and sexual topics, and other aspects of provided services.


Between January and August 2022, a total of 25 patients provided their evaluations. Of these participants, 17 (68%) were females. The mean age of participants was 40.2 (+/-13) years. About 56% of these patients attended the clinic accompanied by their partners, parents, or other family members. About 70% of clinic encounters had 3 or more healthcare workers present. Details of encounters are illustrated in table 1. Responses to questionnaire statements are summarized in table 2, graph 1 and 2.

Table 1 Table 2
Graph 1
Graph 2


The joint fistula clinic was positively perceived by patients, the majority of whom reported feeling comfortable discussing intimate sexual issues. Contrary to what was expected, the presence of multiple healthcare workers during an encounter did not generally make discussions more difficult.

References:(1) Spinelli A, et al. “The impact of perianal fistula in Crohn’s disease on quality of life: Results of a patient survey conducted in Europe”. Poster presentations: Clinical: Therapy and Observation 2021