October 13, 2026
3 min read
Key takeaways:
- Although common in defecatory disorders, erectile dysfunction was linked to urinary, prostate and psychiatric conditions rather than anorectal dysfunction.
- Routine sexual health screening may improve care.
NASHVILLE, Tenn. — Erectile dysfunction was reported among 38% of men evaluated for defecatory disorders and was linked to older age and coexisting urinary, prostate and psychiatric conditions, but not measurable anorectal dysfunction.
Findings presented at ACG Annual Scientific Meeting indicated that erectile dysfunction in this population may be the result of overlapping comorbidities and highlight the importance of assessing pelvic health beyond bowel symptoms alone.
Syed Matthew Kodilinye, MD, speaks during ACG Annual Scientific Meeting. Photo: Robert Stott.
“Most of what we know about defecatory disorders comes from studies of women, and the findings are often extrapolated to men,” Syed Matthew Kodilinye, MD, a gastroenterology and hepatology fellow at Mayo Clinic in Scottsdale, Arizona, told Healio regarding his presentation. “In clinic, we noticed that many men referred for defecatory symptoms also had erectile dysfunction, but they usually mentioned it only when asked directly. ED is an embarrassing topic for both patients and providers, and sexual function in these men has received very little attention.”
Kodilinye noted that “anorectum and the penis share nerve supply from the same sacral spine segments,” which led researchers to investigate how often erectile dysfunction and defecatory disorder occur together and whether men with both conditions exhibit distinct patterns on anorectal testing.
The researchers retrospectively reviewed adult men who underwent high-resolution anorectal manometry and balloon expulsion testing for defecatory symptoms at a tertiary care center between 2017 and 2025. They compared baseline characteristics and manometry findings in men with and without erectile dysfunction, using regression analyses to evaluate potential associations.
Among 717 men evaluated for defecatory symptoms, 271 (37.8%) exhibited erectile dysfunction; these men were significantly older than those without the condition (median age, 68 vs. 46 years; P < .001). They also had higher rates of cardiovascular disease and psychiatric disorders.
Although constipation and irritable bowel syndrome rates were similar between groups, fecal incontinence was more common among men with erectile dysfunction (33.2% vs. 18.2%; P < .001). Prostate conditions and urinary symptoms also were more prevalent in this group.
After adjustment for age, erectile dysfunction remained significantly associated with psychiatric disorders, fecal incontinence, urinary symptoms and prostate conditions. However, age-adjusted anorectal pressure profiles and balloon expulsion test results did not differ significantly between men with and without erectile dysfunction.
Among men aged younger than 45 years, diabetes was the strongest predictor for erectile dysfunction (OR = 6.35; 95% CI, 1.53-26.31), followed by urinary symptoms (OR = 3.68; 95% CI, 1.81-7.12) and rectal hypersensitivity (OR = 2.42; 95% CI, 1.05-5.57).
Among men aged older than 45 years, prostate disease was the strongest predictor (OR = 3.32; 95% CI, 2.09-5.26), followed by urinary symptoms (OR = 1.95; 95% CI, 1.26-3) and psychiatric comorbidities (OR = 1.63; 95% CI, 1.09-2.43).
“The most interesting finding to me was a modest association between rectal hypersensitivity and ED in men under 50, which was not present in older men,” Kodilinye told Healio. “Rectal hypersensitivity means the rectum senses filling at lower volumes than normal. In younger men, cardiovascular disease is less likely to explain ED, so a link with altered rectal sensation raises the possibility of a shared sensory process in the pelvis, or altered processing of pelvic signals in the brain. In other words, it may reflect a dysregulated ‘brain–gut–pelvic floor’ axis.”
Given the high prevalence of erectile dysfunction among men with defecatory symptoms, Kodilinye emphasized that clinicians should be addressing sexual health as part of routine evaluation.
“It’s one question, it takes seconds and many men won’t bring it up on their own,” he said. “When a man is already seeing us for defecatory symptoms, that visit is an opportunity to identify ED early and refer to urology or other specialists before it goes unaddressed for years. ED is often written off as a normal part of aging, but early evaluation can uncover treatable causes, including vascular, neurologic or medication-related ones, and connect the patient to care he might never have sought on his own.”
For more information:
Syed Matthew Kodilinye, MD, can be reached at gastroenterology@healio.com.
Sources/Disclosures
Source:
Kodilinye SM, et al. Erectile dysfunction in men with defecatory symptoms is associated with distinct clinical characteristics but comparable anorectal physiologic profiles. Presented at: ACG Annual Scientific Meeting; Oct 12-14, 2026; Nashville, Tenn. (hybrid meeting).
Disclosures:
Kodilinye reports no relevant financial disclosures. Please see the study for all other authors’ relevant financial disclosures.
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