Gender‐related differences in visceral perception in health and irritable bowel syndrome

Kim, Hyun Seo; Rhee, Poong–Lyul; Park, Jung Ho; Lee, Jun Haeng; Kim, Young‐Ho; Kim, Jae Jun; Rhee, Jong Chul

doi:10.1111/j.1440-1746.2005.04060.x

Cited by 30 publications

(24 citation statements)

References 26 publications

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“…In a recent study of 58 IBS patients (34 men, 24 women) and 26 healthy controls, we showed that women with IBS had greater visceral sensitivity to rectosigmoid phasic distentions, with signifi cantly lower rectal discomfort thresholds, than healthy women or men with IBS [ 26 ]. However, in another study of 59 IBS patients (31 women and 28 men) and 21 healthy controls, Kim et al [ 27 ] found that there were no differences between women and men with IBS in visceral perception of ascending rectal distention. The differences in these two studies are likely to be due to methodologic differences.…”

Section: Computerized Barostat Distention Devicementioning

confidence: 61%

“…For example, Chang et al [ 26 ] measured rectal discomfort thresholds to randomized, phasic distentions before and after noxious sensitizing sigmoid distentions and showed greater induction of rectal perception, particularly in women. In contrast, Kim et al [ 27 ] administered rectal distentions only, given in an ascending manner, which is more vulnerable to response bias. Pressure thresholds to fi rst sensation, sense of urge to defecate, and maximal tolerated distention-but not pain or discomfort-were measured.…”

Section: Computerized Barostat Distention Devicementioning

confidence: 92%

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Novel techniques to study visceral hypersensitivity in irritable bowel syndrome

Truong¹,

Naliboff²,

Chang

2008

Curr Gastroenterol Rep

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Visceral hypersensitivity has emerged as a key hypothesis in explaining the painful symptoms of irritable bowel syndrome (IBS), and it has been proposed as a "biologic marker" for the condition. Visceral hypersensitivity can be influenced by peripheral and central mechanisms affecting pain perception. The optimal method for its assessment in humans has not been determined. Current techniques include stimulation via the computerized barostat and electrical stimulation, response measures including the lower limb reflex, and brain imaging modalities such as functional MRI and positron emission tomography. It has been shown that IBS patients have decreased sensory thresholds to colonic and rectal balloon distention by barostat. Studies using electrical stimulation and the RIII lower limb reflex have further confirmed enhanced visceral perception in IBS. Evidence from more recent neuro-imaging studies suggests that IBS patients have abnormal activation of brain circuits involved in emotional and cognitive modulation of sensory information, resulting in ineffective pain modulation; these circuits may have a pathophysiologic role in enhancing visceral perception. There are few effective pharmacologic treatments that relieve IBS symptoms, and improved understanding of brain-gut interactions and factors relating to enhanced visceral perception may guide us in developing more efficacious treatments.

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Section: Computerized Barostat Distention Devicementioning

confidence: 61%

Section: Computerized Barostat Distention Devicementioning

confidence: 92%

Novel techniques to study visceral hypersensitivity in irritable bowel syndrome

Truong¹,

Naliboff²,

Chang

2008

Curr Gastroenterol Rep

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“…Sloots et al [40] determined a greater rectal capacity and compliance in males which could account for the observed lower perception threshold in females. However, recent Barostat measurements confirm a heightened perception in females and the deterioration of sensitivity with age [41,42]. …”

Section: Discussionmentioning

confidence: 99%

Influence of Gender and Age on Anorectal Function: Normal Values from Anorectal Manometry in a Large Caucasian Population

Gundling

Seidl²,

Scalercio³

et al. 2010

Digestion

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Introduction: In the literature, data on the effects of gender and age on the pressure data of anorectal manometry differ. Possible reasons are investigation of only small numbers of healthy people and comparison of only 2 groups with large age differences. In addition, data about the influence of gender or age on anorectal sensation are sparse. Therefore, the aim of the present study was to determine the influence of gender and age on anorectal manometry in a large healthy female and male cohort spanning a great age range. Methods: Anorectal manometry was performed in 72 women and 74 men with a median age of 64 years in both groups (ranges: women 22–90 years; men 23–88 years). We determined mean anal resting and squeeze pressure as well as minimal rectal balloon volume for perception and for urge/desire to defecate. The Mann-Whitney U test was used to analyze for gender differences, regression analysis to search for age influences. Results: Squeeze pressure (p = 0.007) and perception threshold (p < 0.001) are significantly lower in females, while the mean resting pressure and urge threshold are similar in females and males. Mean resting pressure (women p < 0.0001; men p = 0.03) and mean squeeze pressure decrease (women p < 0.0001; men p = 0.004) with age. An age-related increase in sensory thresholds (= decreased rectal sensitivity) is only seen in females (perception threshold p = 0.01; urge threshold p = 0.04). Conclusion: Most of the parameters measured by anorectal manometry (anal canal pressure, sensory thresholds) are influenced by gender and age. Therefore, the results of anorectal manometry must be interpreted in relation to sex- and age-adapted normal values.

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“…In one study based on a community sample of patients, women with IBS reported more symptoms of constipation and abdominal discomfort while men with IBS reported more diarrhea [6, 20]. However, such groupings do not seem to be of physiological relevance, and it is not certain whether these differences can be explained based on the pathophysiology of IBS [18]. In this study, patients with IBS were classified into 2 subgroups, a diarrhea-predominant group (IBS-D) and a constipation-predominant group (IBS-C), according to the predominant symptoms.…”

Section: Discussionmentioning

confidence: 99%

“…Patients with IBS can easily be classified into subgroups according to the predominant presenting symptom, namely diarrhea, constipation or mixed types [4, 18, 19]. In one study based on a community sample of patients, women with IBS reported more symptoms of constipation and abdominal discomfort while men with IBS reported more diarrhea [6, 20].…”

Section: Discussionmentioning

confidence: 99%

Male Sex Hormones May Influence the Symptoms of Irritable Bowel Syndrome in Young Men

et al. 2008

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Aims: To evaluate the sex hormone status of young male patients with irritable bowel syndrome (IBS) and to investigate whether there were any differences in bowel symptoms related to the hormone levels. Methods: Thirty-eight young male patients with IBS were compared with 20 healthy young men. Details of symptoms were collected by a structured questionnaire. Each subject underwent a blood test and colonoscopy. The blood test included serum testosterone, free testosterone, sex hormone-binding globulin (SHBG), follicle-stimulating hormone and luteinizing hormone. Based on the questionnaire, patients were classified as having diarrhea-predominant IBS (IBS-D) or constipation-predominant IBS (IBS-C). Results: Among the 38 patients with IBS, 24 had IBS-D and 14 had IBS-C. The patients had higher levels of testosterone and SHBG than did the controls (p = 0.04 and p = 0.03, respectively). However, there was no significant difference between the IBS-D and IBS-C group with regard to the testosterone and SHBG levels (p > 0.05). There was also no difference in the duration and severity of symptoms between these 2 groups (p > 0.05). Conclusions: Sex hormone status in young men differ from those in older men and may play an important role in the pathophysiology of IBS, regardless of the dominant symptom type.

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Gender‐related differences in visceral perception in health and irritable bowel syndrome

Cited by 30 publications

References 26 publications

Novel techniques to study visceral hypersensitivity in irritable bowel syndrome

Novel techniques to study visceral hypersensitivity in irritable bowel syndrome

Influence of Gender and Age on Anorectal Function: Normal Values from Anorectal Manometry in a Large Caucasian Population

Male Sex Hormones May Influence the Symptoms of Irritable Bowel Syndrome in Young Men

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