Age, Gender, and Women’s Health and the Patient

Patients with functional gastrointestinal disorders (FGIDs) often experience distress, reduced quality of life, a perceived lack of validation, and an unsatisfactory experience with health care providers. A health care provider can provide the patient with a framework in which to understand and legitimize their symptoms, remove self-doubt or blame, and identify factors that contribute to symptoms that the patient can influence or control. This framework is implemented with the consideration of important factors that impact FGIDs, such as gender, age, society, and the patient’s perspective. Although the majority of FGIDs, including globus, rumination syndrome, irritable bowel syndrome, bloating, constipation, functional abdominal pain, sphincter of Oddi dyskinesia, pelvic floor dysfunction, and extraintestinal manifestations, are more prevalent in women than in men, functional chest pain, dyspepsia, vomiting, and anorectal pain do not appear to vary by gender. Studies have suggested sex differences in somatic, but not visceral, pain perception, motility, and central processing of visceral pain; although further research is required in autonomic nervous system dysfunction, genetics, and immunologic/microbiome. Gender differences in response to psychological treatments, antidepressants, fiber, probiotics, and anticholinergics have not been studied adequately. However, a greater clinical response to 5-HT3 antagonists but not 5-HT4 agonists has been reported in women compared with men.