Irritable bowel syndrome (IBS) is a disorder characterized by abdominal pain or discomfort and altered bowel habit (chronic or recurrent diarrhea, constipation, or both – either mixed or in alternation).*

Up to 45 million people living in the United States suffer from IBS. For most people, IBS is best understood as a long-term or chronic condition (lasting more than 6 months) in which reoccurring issues with abdominal pain or discomfort associated in some way with their bowel movements. Although IBS is common, patients are often stigmatized and misunderstood, and the symptoms significantly impact their quality of life.

The causes of IBS are not completely understood. There is a tendency for the bowel to be overly reactive to various factors, like; stress, emotional arousal, GI infections, menstrual period, or gaseous distension. There are also possible factors like genetics and prior adverse life experiences (e.g., infection, trauma) that can predispose someone to get IBS.

Your stomach’s link to the nervous system

When the digestive system is not working properly, symptoms like diarrhea, constipation, vomiting, and abdominal pain can occur. These responses all involve the actions of the enteric nervous system (ENS), which has many special features, including:

Sensitivity: The ENS can sense invasive organisms like bacteria and viruses. This activates a protective response like vomiting or diarrhea. It can also sense nutrients and activate digestion.
Intestinal motility: The ENS processes information about nutrients and invading pathogens. This activates the appropriate gut behaviors, like mixing contents around for digestion or propelling them along the gut for elimination.
Secretion: This system also can activate or suppress the activities of muscles or glands in the gut.

IBS is not just a Women's issue.

Social media ads and other media outlets tend to portray IBS as a problem that only women develop. These gastrointestinal (GI) diseases and disorders affect people of all genders. The ways it manifests vary depending on biological sex and gender role. Researchers have been more likely to focus on how the condition affects women than on how it affects men. Consequently, men are often excluded from studies.4

Approximately 60% to 65% of individuals who report IBS are female. This chronic, often debilitating, functional gastrointestinal disorder shows that females with IBS experience a change in symptoms at various stages of the menstrual cycle, leading researchers to believe that there may be a hormonal link. Data also reveal an increased risk of unnecessary surgery for extra-abdominal and abdominal surgery in IBS patients. For example, hysterectomy or ovarian surgery has been reported in female patients with IBS as high as 47% to 55% and has been performed more often in the IBS patient than in comparison groups.1

Men are less likely to experience pain with IBS, and healthcare providers believe that testosterone and other androgens (male hormones) could be the cause.4 Androgens are natural steroids, and testosterone is an androgen. Research has indicated that higher levels of androgens lower a person's risk of developing a chronic pain disorder and that testosterone, in particular, may serve as a natural pain reliever. This might play into why pain is a predominant symptom of IBS in women, but not in men, and can partially explain why women report IBS symptoms more often than men. The stereotype could be an unfortunate misperception for men who may have digestive symptoms caused by IBS. Men may not get the help they might need simply because they assume that something else is going on.

*aboutIBS.org

1 https://aboutibs.org/what-is-ibs/facts-about-ibs/statistics/

2 https://badgut.org/information-centre/a-z-digestive-topics/gender-gut/

3 Thakur ER, Gurtman MB, Keefer L, Brenner DM, Lackner JM. Representing the IBS Outcome Study Research Group. Gender differences in irritable bowel syndrome: the interpersonal connection. Neurogastroenterol Motil. 2015;27(10):1478–1486. doi:10.1111/nmo.12647

4 Kim YS, Kim N. Sex-Gender Differences in Irritable Bowel Syndrome. J Neurogastroenterol Motil. 2018;24(4):544–558. doi:10.5056/jnm18082