Gender-related differences in IBS symptoms

OBJECTIVE: Women are more likely than men to report irritable bowel syndrom e (IBS) symptoms as well as chronic visceral and musculoskeletal pain. The study tests the general hypothesis that female IBS patients differ from the ir male counterparts in symptoms related to the viscera and musculoskeletal system, and that these differences are related to the menstrual cycle. METHODS: Seven hundred fourteen Rome positive IBS patients were evaluated f or GI and extracolonic symptoms, psychological symptoms (SCL-90R), and qual ity of Life (QOL) (SF-36). In addition, 54 postmenopausal women were compar ed with 61 premenopausal women and 54 age-matched mates, all with IBS. RESULTS: Male and female subjects reported similar GI levels of symptom;sev erity and psychological problems. Abdominal distension associated with a se nsation of bloating was more commonly reported by female patients, as were symptoms of constipation. Female patients more often reported nausea, alter ations of taste and smell, and unpleasant sensations on the tongue, muscle stiffness in the morning, greater food sensitivity, and side effects from m edications. Forty percent of female patients reported menstrual cycle-relat ed worsening of symptoms, but few symptom differences were found between pr e- and postmenopausal women, making it unlikely that most of the gender dif ferences observed are directly tied to the menstrual cycle. CONCLUSIONS: Female patients report higher levels of a variety of intestina l and nonintestinal sensory symptoms despite similar levels of IBS severity , abdominal pain, psychological symptoms, and illness impact. The apparent differences in sensitivity to nonpainful visceral sensations, medications, and food may represent altered sensory processes, autonomic responses, and/ or cognitive hypervigilance. (C) 2001 by Am. Coll. of Gastroenterology.