Crohn’s disease can come with many frustrations and challenges. Maintaining a satisfying sex life can be a particularly difficult challenge. Abdominal pain, gas, bloating, diarrhea, and the need to find a bathroom in a hurry are all aspects of Crohn’s disease that don’t sound the least bit sexy.

But there are ways to cope with your symptoms and have a satisfying sex life.

Body image issues that result from scarring after surgery, ostomy bags, and fistula around the anal and genital area can make sex painful and take an emotional toll on your sexual self-esteem. Fear of bowel accidents or the sudden need to rush to the bathroom in the middle of an erotic encounter can dampen your enthusiasm for sex, intimacy, or affection.

Each new relationship brings the task of disclosing your condition and explaining your Crohn’s symptoms and coping methods. Your partner may become frustrated if you pull away from them, avoid intimacy, or refuse to discuss feelings and methods that allow sex to be possible. They may fear hurting you physically during sex by harming your ostomy area or causing you pain during sex due to fistulas. This fear can make your partner afraid to touch or make love to you.

Here’s a basic human fact that no one wants to talk about in life: Everyone poops.

That’s in no way meant to minimize what you experience with Crohn’s. It’s just to say if you’re going to have an honest and mature conversation about sexuality, it has to include bodily functions. That way, when they don’t function the way you want them to, you can be more comfortable dealing with them.

Find ways to be sexual when experiencing windows of wellness. Cope with symptoms as they occur — including during intimacy. And have courage to have a sex life.

If you have an ostomy bag, change the bag just prior to sex and talk to your doctor about how to secure it so it doesn’t come loose during sex.

Talk to your doctor about fistulas in your anal or genital area that make sex uncomfortable or painful. Fistulas can often be treated.

Pad the bed before having sex if you’re worried about a bowel accident. This will make clean up easier. If it does occur, try not to let it define your romantic encounter. Clean it up and try again.

Be informed about sexual side effects of medication. Some may lower sex drive. In women, corticosteroids may contribute to vaginal yeast infections. Discuss these issues with your doctor and ask what you can do. However, do not stop using any medication without checking with your doctor first.

Learn about your body in as much detail as possible. Learn what triggers a Crohn’s flare for you. Learn to recognize the signs of an impending attack. Once you get to know these things, you can adapt your sexual schedule accordingly.

Find other ways to express intimacy and love besides intercourse. Relationships are more than sex. Having a partner you can talk to about these issues is a form of intimacy in itself.

Communicate with each other. Be honest about your feelings, fears, and comfort level with coping methods. Ask your partner how they feel about it. Have patience with your partner. Explain how the condition works and how you cope with it.

Don’t be afraid to go outside your comfort zone and seek outside professional help. Many couples dealing with a chronic illness benefit from talking to a counselor or sex therapist. It can go a long way in helping you reclaim your sex life.