Contribution of gender to pathophysiology and clinical presentation of IBS: should management be different in women?
The irritable bowel syndrome (IBS) is found more commonly in women than men. It is more prevalent in patients with chronic fatigue syndrome, fibromyalgia, and chronic pelvic pain, all syndromes characterized by pain and found predominantly in women. This article reviews evidence for a role of biological sex factors and gender on the pathways mediating visceral pain. The effect of gonadal hormones on gastrointestinal motility and the sensory afferent pathway and central processing of visceral stimuli and the contribution of gender role to the clinical presentation are discussed. Although differences in responses to treatment modalities between genders exist, the approach to IBS patients in both genders is quite similar. Nevertheless, a special attention to gender role and stress-related factors should be addressed. New developments in research, outlined in the paper, might bring more gender-specific treatments in the future.
Ouyang
Ann
A
Division of Gastroenterology and Hepatology, The Milton S. Hershey Medical Center, College of Medicine, Pennsylvania State University, Hershey, Pennsylvania 17033, USA.
Wrzos
Helena F
HF
D004967:Estrogens / Q000502:physiology; D005260:Female; D042341:Gonadal Hormones / Q000502:physiology; D006801:Humans; D043183:Irritable Bowel Syndrome / Q000175:diagnosis / Q000503:physiopathology / Q000523:psychology / Q000628:therapy*; D008297:Male; D012727:Sex Characteristics; D012737:Sex Factors
D004967:Estrogens; D042341:Gonadal Hormones