title: Age, Gender and Women's Health and the Patient.
abstract: Patients with functional gastrointestinal disorders (FGIDs) often experience distress, reduced quality of life, a perceived lack of validation, and an unsatisfactory experience with health care providers. A health care provider can provide the patient with a framework in which to understand and legitimize their symptoms, remove self-doubt or blame, and identify factors that contribute to symptoms that the patient can influence or control. This framework is implemented with the consideration of important factors that impact FGIDs, such as gender, age, society, and the patient's perspective. Although the majority of FGIDs, including globus, rumination syndrome, IBS, bloating, constipation, functional abdominal pain, sphincter of Oddi dyskinesia, pelvic floor dysfunction, and extra-intestinal manifestations, are more prevalent in women than men, functional chest pain, dyspepsia, vomiting, and anorectal pain do not appear to vary by gender. Studies suggest sex differences in somatic but not visceral pain perception, motility, and central processing of visceral pain; although further research is required in autonomic nervous system dysfunction, genetics and immunologic/microbiome. Gender differences in response to psychological treatments, antidepressants, fiber, probiotics, and anticholinergics have not been adequately studied. However, a greater clinical response to 5-HT3antagonists but not 5-HT4agonists has been reported in women compared with men.
authors.affiliation: Division of Gastroenterology and Hepatology, Mayo Clinic, Jacksonville, FL, USA; Centre for Gastrointestinal Sciences, University of Manchester, Manchester, UK. Electronic address: Houghton.Lesley@mayo.edu.
authors.forename: Lesley A
authors.initials: LA
authors.lastname: Houghton
authors.affiliation: University of Washington, Seattle, Washington, USA.
authors.forename: Margaret
authors.initials: M
authors.lastname: Heitkemper
authors.affiliation: Division of Gastroenterology and Hepatology Mayo Clinic, Scottsdale, Arizona, USA.
authors.forename: Michael
authors.initials: M
authors.lastname: Crowell
authors.affiliation: University College London, London, UK.
authors.forename: Anton
authors.initials: A
authors.lastname: Emmanuel
authors.affiliation: Boston Medical Center, Boston, MA, USA.
authors.forename: Albena
authors.initials: A
authors.lastname: Halpert
authors.affiliation: University of California, Los Angeles, CA, USA.
authors.forename: James A
authors.initials: JA
authors.lastname: McRoberts
authors.affiliation: University of Toronto, Toronto, Ontario, CAN.
authors.forename: Brenda
authors.initials: B
authors.lastname: Toner
keywords: Sex; development; society; symptoms