Impact of Sex and Gender on Irritable Bowel Syndrome

Irritable bowel syndrome (IBS) is a common functional bowel disorder characterized by abdominal pain and change in defecation pattern. This review addresses the topic of possible sex (genetic, biological) and gender (experiential, perceptual) differences in individuals with and without IBS. Several observations make the topic important. First, there is a predominance of women as compared to men who seek health care services for IBS in the United States and other industrialized societies. Second, menstrual cycle-linked differences are observed in IBS symptom reports. Third, women with IBS tend to report greater problems with constipation and nongastrointestinal complaints associated with IBS. Fourth, serotonin (5-HT3) receptor antagonist and 5-HT4 partial agonist drugs appear to more effectively diminish reports of bowel pattern disruption in women with IBS as compared to men. This review examines sex and gender modulation of gastrointestinal motility and transit, visceral pain sensitivity, autonomic nervous system function, serotonin biochemistry, and differences in health care-seeking behavior for IBS.

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Irritable Bowel Syndrome: Epidemiology, Natural History, Health Care Seeking and Emerging Risk Factors

Gastroenterology Clinics of North America ◽

10.1016/j.gtc.2005.02.008 ◽

2005 ◽

Vol 34 (2) ◽

pp. 189-204 ◽

Cited By ~ 135

Author(s):

Filippo Cremonini ◽

Nicholas J. Talley

Keyword(s):

Risk Factors ◽

Health Care ◽

Irritable Bowel Syndrome ◽

Natural History ◽

Health Care Seeking ◽

Care Seeking ◽

Emerging Risk ◽

Irritable Bowel

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“When the pain is so acute or if I think that I’m going to die”: Health care seeking behaviors and experiences of transgender and gender diverse people in an urban area

PLoS ONE ◽

10.1371/journal.pone.0246883 ◽

2021 ◽

Vol 16 (2) ◽

pp. e0246883

Author(s):

Mandi L. Pratt-Chapman ◽

Jeanne Murphy ◽

Dana Hines ◽

Ruta Brazinskaite ◽

Allison R. Warren ◽

...

Keyword(s):

Health Care ◽

Cancer Screening ◽

Care Coordination ◽

The United States ◽

Health Care Seeking ◽

Provider Communication ◽

Care Seeking ◽

Gender Diverse ◽

And Gender ◽

Health Care Seeking Behaviors

Introduction Approximately 1.4 million transgender and gender diverse (TGD) adults in the United States have unique health and health care needs, including anatomy-driven cancer screening. This study explored the general healthcare experiences of TGD people in the Washington, DC area, and cancer screening experiences in particular. Methods Twenty-one TGD people were recruited through word of mouth and Lesbian Gay Bisexual Transgender Queer (LGBTQ)-specific community events. Participant interviews were conducted and recorded via WebEx (n = 20; one interview failed to record). Interviews were transcribed using Rev.com. Two coders conducted line-by-line coding for emergent themes in NVivo 12, developed a codebook by consensus, and refined the codebook throughout the coding process. Member checking was conducted to ensure credibility of findings. Results Three major themes served as parent nodes: health-care seeking behaviors, quality care, and TGD-specific health care experiences. Within these parent nodes there were 14 child nodes and 4 grand-child nodes. Subthemes for health care seeking behaviors included coverage and costs of care, convenience, trust/mistrust of provider, and provider recommendations for screening. Subthemes for quality of care included professionalism, clinical competence in transgender care, care coordination, provider communication, and patient self-advocacy. Overall, transgender men were less satisfied with care than transgender women. Conclusions Results suggest a need for improved provider communication skills, including clear explanations of procedures and recommendations for appropriate screenings to TGD patients. Results also suggest a need for improved clinical knowledge and cultural competency. Respondents also wanted better care coordination and insurance navigation. Overall, these findings can inform health care improvements for TGD people.

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New Treatments for Irritable Bowel Syndrome in Women

Women s Health ◽

10.2217/17455057.4.6.605 ◽

2008 ◽

Vol 4 (6) ◽

pp. 605-622 ◽

Cited By ~ 11

Author(s):

Mopelola A Adeyemo ◽

Lin Chang

Keyword(s):

Irritable Bowel Syndrome ◽

Healthcare Services ◽

Sex And Gender ◽

Emerging Therapies ◽

Female Predominance ◽

Related Quality ◽

Health Related ◽

And Gender ◽

Irritable Bowel ◽

New Treatments

The estimated prevalence of irritable bowel syndrome (IBS) in Western countries is 7–15%, with a female:male ratio of 2–2.5:1 in IBS patients who seek healthcare services; however, the female predominance is lower in the general population. IBS has a significant impact on health-related quality of life and is associated with a significant healthcare and economic burden. Management of IBS is comprised of general measures and pharmacologic and nonpharmacologic treatment. However, there are ongoing efforts to find more effective therapeutic approaches. As advancements in the understanding of the pathophysiology of IBS continue to grow, new and effective treatments with novel mechanisms of action that have the potential to improve relief of IBS symptoms over current treatments are likely to be developed. This article provides an overview of current and emerging therapies for IBS and also highlights sex and gender differences in clinical trials and treatment response.

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Socioeconomic Impact of Irritable Bowel Syndrome in Canada

Canadian Journal of Gastroenterology ◽

10.1155/2001/401309 ◽

2001 ◽

Vol 15 (suppl b) ◽

pp. 8B-11B ◽

Cited By ~ 18

Author(s):

Michel Boivin

Keyword(s):

Health Care ◽

Irritable Bowel Syndrome ◽

Health Care Services ◽

Financial Burden ◽

Treatment Options ◽

Indirect Costs ◽

The United States ◽

Physician Patient Relationship ◽

Intangible Costs ◽

Irritable Bowel

Irritable bowel syndrome (IBS) is the most common functional gastroenterological disorder reported to physicians. In Canada, its prevalence is about 6%. In the United States and the United Kingdom, the prevalence is estimated to be closer to 15%. Patients with IBS tend to make extensive use of health care services, even though a high percentage of them do not seek medical advice. The costs of IBS are a large expenditure of scarce resources. These costs can be divided into several categories: direct, indirect and intangible costs. The direct costs, associated with the diagnosis and treatment, are largely sustained by the health care system. The indirect costs are related to the production losses due to morbidity, and intangible costs are associated with the pain, suffering and alteration in the patient’s quality of life. The condition is a diagnosis of exclusion, and treatment, although beneficial, is rarely curative. The general treatment approach stresses the importance of a good physician-patient relationship. Exploring the nature of the expenses associated with IBS and understanding how treatment options may affect these costs are essential to reducing its financial burden.

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Predictors of health care seeking for irritable bowel syndrome: a population based study

Gut ◽

10.1136/gut.41.3.394 ◽

1997 ◽

Vol 41 (3) ◽

pp. 394-398 ◽

Cited By ~ 163

Author(s):

N J Talley ◽

P M Boyce ◽

M Jones

Keyword(s):

Health Care ◽

Irritable Bowel Syndrome ◽

Medical Care ◽

Psychological Factors ◽

Population Based ◽

Pain Severity ◽

Health Care Seeking ◽

Care Seeking ◽

Population Based Study ◽

Irritable Bowel

Background—It has been suggested that psychological factors rather than symptoms drive subjects with irritable bowel syndrome (IBS) to seek medical care, but this issue has not been tackled in a population based study.Aim—To identify whether psychological factors or abuse explain health care seeking for IBS.Methods—A sample of residents of Penrith (a Sydney suburb representative of the Australian population) selected randomly from the electoral rolls (that by law include the entire population ⩾18 years) was mailed a validated self-report questionnaire. Measured were gastrointestinal symptoms including the Manning (and Rome) criteria for IBS, health care seeking, neuroticism (Eysenck Personality Questionnaire), psychological morbidity (General Health Questionnaire: GHQ) and sexual, physical and emotional abuse (including the standardised Drossman questions).Results—Among 730 subjects, 96 (13%, 95% confidence interval (CI) 11–16%) had IBS by the Manning criteria. Of those with IBS, 73% (95% CI 63–81%) had sought medical care for abdominal pain or discomfort. Only increasing pain severity (odds ratio (OR) = 2.10, 95% CI 1.11–3.95) and duration of pain (OR=1.53, 95% CI 1.10–2.13) were independently associated with seeking health care for IBS. Pain severity was also predictive of recent care seeking (OR=1.74, 95% CI 1.12–1.96). Neuroticism, psychological morbidity and abuse history were not significant predictors.Conclusion—Psychological factors do not seem to explain health care seeking among community subjects with IBS.

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