Objective: Women are more likely than men to report irritable bowel syndrome (IBS) symptoms as well as chronic visceral and musculoskeletal pain. The study tests the general hypothesis that female IBS patients differ from their 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 for GI and extracolonic symptoms, psychological symptoms (SCL-90R), and quality of life (QOL) (SF-36). In addition, 54 postmenopausal women were compared with 61 premenopausal women and 54 age-matched males, all with IBS.
Results: Male and female subjects reported similar GI levels of symptom severity and psychological problems. Abdominal distension associated with a sensation of bloating was more commonly reported by female patients, as were symptoms of constipation. Female patients more often reported nausea, alterations of taste and smell, and unpleasant sensations on the tongue, muscle stiffness in the morning, greater food sensitivity, and side effects from medications. Forty percent of female patients reported menstrual cycle-related worsening of symptoms, but few symptom differences were found between pre- and postmenopausal women, making it unlikely that most of the gender differences observed are directly tied to the menstrual cycle.
Conclusions: Female patients report higher levels of a variety of intestinal 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.