Targownik Laura E, Bollegala Natasha, Huang Vivian H, Windsor Joseph W, Kuenzig M Ellen, Benchimol Eric I, Kaplan Gilaad G, Murthy Sanjay K, Bitton Alain, Bernstein Charles N, Jones Jennifer L, Lee Kate, Peña-Sánchez Juan-Nicolás, Rohatinsky Noelle, Ghandeharian Sara, Davis Tal, Weinstein Jake, Im James H B, Jannati Nazanin, Khan Rabia, Matthews Priscilla, Jones May Tyrel, Tabatabavakili Sahar, Jogendran Rohit, Hazan Elias, Browne Mira, Meka Saketh, Vukovic Sonya, Jogendran Manisha, Hu Malini, Osei Jessica Amankwah, Wang Grace Y, Sheekha Tasbeen Akhtar, Dahlwi Ghaida, Goddard Quinn, Gorospe Julia, Nisbett Cyanne, Gertsman Shira, Sousa James, Morganstein Taylor, Stocks Taylor, Weber Ann, Seow Cynthia H
Division of Gastroenterology and Hepatology, Mount Sinai Hospital, University of Toronto, Toronto, Ontario, Canada.
Department of Gastroenterology, Women's College Hospital, Toronto, Ontario, Canada.
J Can Assoc Gastroenterol. 2023 Sep 5;6(Suppl 2):S55-S63. doi: 10.1093/jcag/gwad011. eCollection 2023 Sep.
Sex (the physical and physiologic effects resulting from having specific combinations of sex chromosomes) and gender (sex-associated behaviours, expectations, identities, and roles) significantly affect the course of inflammatory bowel disease (IBD) and the experience of living with IBD. Sex-influenced physiologic states, like puberty, the menstrual cycle, pregnancy, and andropause/menopause may also impact and be impacted by IBD. While neither Crohn's disease nor ulcerative colitis is commonly considered sex-determined illnesses, the relative incidence of Crohn's disease and ulcerative colitis between males and females varies over the life cycle. In terms of gender, women tend to use healthcare resources at slightly higher rates than men and are more likely to have fragmented care. Women are more commonly prescribed opioid medications and are less likely than men to undergo colectomy. Women tend to report lower quality of life and have higher indirect costs due to higher rates of disability. Women are also more likely to take on caregiver roles for children with IBD. Women with IBD are more commonly burdened with adverse mental health concerns and having poor mental health has a more profound impact on women than men. Pregnant people with active IBD have higher rates of adverse outcomes in pregnancy, made worse in regions with poor access to IBD specialist care. The majority of individuals with IBD in Canada do not have access to a pregnancy-in-IBD specialist; access to this type of care has been shown to allay fears and increase knowledge among pregnant people with IBD.
性别（由特定性染色体组合产生的生理和生理效应）和社会性别（与性别相关的行为、期望、身份和角色）会显著影响炎症性肠病（IBD）的病程以及IBD患者的生活体验。受性别影响的生理状态，如青春期、月经周期、怀孕以及男性更年期/女性更年期，也可能影响IBD并受到IBD的影响。虽然克罗恩病和溃疡性结肠炎通常都不被视为由性别决定的疾病，但克罗恩病和溃疡性结肠炎在男性和女性之间的相对发病率在生命周期中有所不同。在社会性别方面，女性使用医疗资源的比例往往略高于男性，并且更有可能接受不连续的治疗。女性更常被开阿片类药物，并且比男性接受结肠切除术的可能性更小。女性往往报告生活质量较低，并且由于残疾率较高而间接成本更高。女性也更有可能承担患有IBD的儿童的照料者角色。患有IBD的女性更常受到不良心理健康问题的困扰，而且心理健康状况不佳对女性的影响比对男性更为深远。患有活动性IBD的孕妇在孕期出现不良结局的几率更高，在难以获得IBD专科护理的地区情况更糟。加拿大大多数患有IBD的人无法获得IBD妊娠专科医生的服务；已证明获得此类护理可以减轻患有IBD的孕妇的恐惧并增加她们的知识。
