Gender and irritable bowel syndrome: the male connection

Irritable bowel syndrome is more common in women; and this is generally considered to be caused by increased susceptibility. However, the opposite possibility that being male might actually protect from the disorder in some way, has largely been ignored. We have noticed that men with IBS seem to display less masculine and more feminine qualities and it was the purpose of this study to confirm or refute this clinical observation.

Seventy consecutive male, secondary care outpatients fulfilling the Rome 1 criteria for irritable bowel syndrome and 70 controls completed a questionnaire to determine male and female-trait scores. In addition, all subjects were assessed using the hospital anxiety depression inventory.

A highly significant reduction in male-trait scores was observed in the irritable bowel syndrome patients compared with controls (-10.5[-15.7,-5.2] P < 0.001). There were no differences between the groups with respect to female-trait scores. The prevalence of homosexuality was no different between patients and controls.

Men with irritable bowel syndrome exhibit less male characteristics and it remains to be determined whether this is cause or effect. Whatever the explanation, this study adds another dimension to the role of gender in functional gastrointestinal disorders.