Kim Young Sun, Kim Nayoung
Department of Internal Medicine, Healthcare Research Institute, Seoul National University Hospital Healthcare System Gangnam Center, Seoul, Korea.
Seoul National University Bundang Hospital, Seongnam, Gyeonggi-do, Korea.
J Neurogastroenterol Motil. 2018 Oct 1;24(4):544-558. doi: 10.5056/jnm18082.
Because of the sex-gender differences that are shown in a diversity of physiological and psychological factors, it can be speculated that the clinical presentation of symptoms as well as treatment strategies in women and men with irritable bowel syndrome (IBS) may differ. Studies have revealed that IBS is more common in women than men. As for the IBS subtype, IBS with constipation is significantly more prevalent among women than men. Sex hormones and gender differences may play important roles in the pathophysiology of IBS. However, its pathophysiologic mechanisms still remain largely unknown, and therapeutic implications are limited. Moreover, women IBS patients have been reported to feel more fatigue, depression, anxiety, and lower quality of life than men IBS patients. Furthermore, there has been evidence of differences in the appropriate treatment efficacy to IBS in men and women, although relatively few men are enrolled in most relevant clinical trials. A more sex-gender-oriented approach in the medical care setting could improve understanding of heterogeneous patients suffering from IBS. An individualized and multicomponent approach including sex and gender issues might help improve the treatment of IBS.
由于在多种生理和心理因素中存在性别差异，可以推测，患有肠易激综合征（IBS）的女性和男性的症状临床表现以及治疗策略可能有所不同。研究表明，IBS在女性中比在男性中更常见。至于IBS亚型，便秘型IBS在女性中比在男性中明显更为普遍。性激素和性别差异可能在IBS的病理生理学中起重要作用。然而，其病理生理机制在很大程度上仍然未知，治疗意义有限。此外，据报道，女性IBS患者比男性IBS患者感到更疲劳、抑郁、焦虑，生活质量更低。此外，尽管在大多数相关临床试验中纳入的男性相对较少，但已有证据表明男性和女性对IBS的适当治疗效果存在差异。在医疗环境中采用更注重性别差异的方法可以增进对患有IBS的异质性患者的了解。包括性别问题在内的个体化和多组分方法可能有助于改善IBS的治疗。
