Sex-Gender Differences in the Effectiveness of Treatment of Irritable Bowel Syndrome: A Systematic Review (original) (raw)
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Irritable bowel syndrome: Does gender matter?
Journal of Psychosomatic Research, 2008
In industrialized parts of the world, women seek health care services for irritable bowel syndrome (IBS) more frequently than men. The role of gender in IBS is likely multifactorial involving inherent physiological differences in gonadal hormones, stress reactivity, and inflammatory responses, as well as sociocultural differences in response to pain and/or bowel pattern changes. This mini-review in particular addresses gender differences in visceral sensitivity, motility, and autonomic nervous system balance as potential factors contributing to gender differences in IBS presentation.
Gender differences in irritable bowel syndrome
Gastroenterology, 2002
Of those who seek health care services, including tertiary and ambulatory care for IBS and other functional Abbreviations used in this paper: ANS, autonomic nervous system; GI, gastrointestinal; HPA, hypothalamic-pituitary-adrenal; HRV, heart rate variability; IBS, irritable bowel syndrome.
Scandinavian Journal of Public Health, 2004
Research has raised concerns about gender bias in medicine, i.e. that men and women might be treated differently due to gender-stereotyped attitudes among physicians. The authors investigated gender differences in medical management of a common health problem, irritable bowel syndrome (IBS). Method: In a national examination for Swedish house officers, the examinees were allocated to suggest management of IBS in either a male or female paper-patient. The case description was identical in both genders with the exception of prior prostate and gynaecological symptoms. The open answers were coded for analysis. A total of 289 physicians (45% women) participated. Chi-squared tests were used to measure differences in proportions. Results: In variables focusing on medication, weight, gynaecological problems, tobacco, alcohol, thyroid function, proposed diagnoses, X-ray of the colon, and advice about lifestyle, significant or close to significant gender differences were seen. Both male and female physicians made gender differences but they did not show the same pattern of differences. Conclusions: The results suggest that gender bias is involved in medical management of IBS but men and women physicians may show disparate patterns of gender bias. There is a need for larger studies on gender differences in medical management with designs making it possible to consider the gender of both the patient and the physician. Furthermore, the results call attention to 'knowledge-mediated gender bias', a phenomenon implying that once knowledge about gender differences in a condition has been established, this might in fact cause gender-biased assessments of individual patients in clinical practice.
Gender-related differences in irritable bowel syndrome: potential mechanisms of sex hormones
World journal of gastroenterology : WJG, 2014
According to epidemiological studies, twice as many women as men are affected by irritable bowel syndrome (IBS) in western countries, suggesting a role for sex hormones in IBS pathophysiology. Despite growing evidence about the implications of sex hormones in IBS symptom modulation, data on mechanisms by which they influence disease development are sparse. This review aims to determine the state of knowledge about the role of sex hormones in sensorimotor dysfunctions and to address the possible interplay of sex hormones with common risk factors associated with IBS. The scientific bibliography was searched using the following keywords: irritable bowel syndrome, sex, gender, ovarian hormone, estradiol, progesterone, testosterone, symptoms, pain, sensitivity, motility, permeability, stress, immune system, brain activity, spinal, supraspinal, imaging. Ovarian hormones variations along the menstrual cycle affect sensorimotor gastrointestinal function in both healthy and IBS populations. ...
Gender differences in irritable bowel syndrome: the interpersonal connection
Neurogastroenterology and Motility
While irritable bowel syndrome (IBS) affects women more than men, the reasons are unclear. Research on the female preponderance of IBS has focused on gender differences in sex-linked biological processes; much less attention has been paid to the role of psychosocial factors. Interpersonal difficulties may be one source of stress that may significantly impact on women with IBS. Because of the importance that women attach to relationships, we suspected they would be more reactive to interpersonal stress. A total of 283 (M age = 41 years, F = 80%), Rome III-diagnosed IBS patients completed a test battery that included the IBS Symptom Severity Scale, McGill Pain Questionnaire, Inventory of Interpersonal Problems (IIP), interpersonal support evaluation list (social support), Negative Interactions Scale, Brief Symptom Inventory (distress), Beck Depression Inventory, Anxiety Sensitivity Inventory, and IBS-Quality of Life as part of baseline assessment of an NIH trial. Males scored higher o...
Italian Journal of Medicine, 2013
Women get sick more, use more health services, take more drugs, and have a higher frequency of serious adverse reactions. Despite this, the drugs we use are little studied in women: both clinical studies and pre-clinical experiments are carried out predominantly in males and the young. Before 1990, no more than 26-30% of women were usually enrolled in a trial, so we lacked the statistical power of showing the efficacy and safety of the drugs being studied in the whole population. The gender blindness (transposition of the male studies in female populations) resulted in a lack of awareness of the differences between males and females, and this prevented both genders from receiving the best possible care. This gender bias also, to a lower degree, hurts men: depression, migraines, osteoporosis have not been studied properly in males. Although the process is slow, the scientific community has begun to pay more attention to direct and indirect influences that gender exercise on biologica...
Sex-based differences in gastrointestinal pain
European Journal of Pain, 2004
Recent interest has focused on sex-related differences in irritable bowel syndrome (IBS) physiology and treatment responsiveness to novel pharmacologic therapies. Similar to a variety of other chronic pain conditions and certain affective disorders, IBS is more prevalent amongst women, both in population-based studies as well as in clinic-based surveys. Non-painful gastrointestinal symptoms, constipation and somatic discomfort are more commonly reported by female IBS patients. While perceptual differences to rectosigmoid stimulation are only observed following repeated noxious stimulation of the gut, sex-related differences in certain sympathetic nervous system (SNS) responses to rectosigmoid stimulation are consistently seen. Consistent with experimental findings in animals, current evidence is consistent with a pathophysiological model which emphasizes sex-related differences in autonomic and antinociceptive responses to certain visceral stimuli.