{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,18]],"date-time":"2026-09-18T15:07:47Z","timestamp":1789744067859,"version":"4.0.1"},"reference-count":43,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2016,11,27]],"date-time":"2016-11-27T00:00:00Z","timestamp":1480204800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Neurogastroenterology Motil"],"published-print":{"date-parts":[[2017,4]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>The epidemiology of chronic constipation (<jats:styled-content style=\"fixed-case\">CC<\/jats:styled-content>) skews toward female predominance, yet men make up an important component of those suffering from <jats:styled-content style=\"fixed-case\">CC<\/jats:styled-content>. We sought to determine whether there are sex\u2010specific differences in symptoms and physiologic parameters on anorectal manometry (<jats:styled-content style=\"fixed-case\">ARM<\/jats:styled-content>).<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We performed a case\u2013control analysis of sequential men and age\u2010matched women (2:1 ratio) presenting for <jats:styled-content style=\"fixed-case\">ARM<\/jats:styled-content> as part of the evaluation of <jats:styled-content style=\"fixed-case\">CC<\/jats:styled-content>. We collected physiologic parameters derived from 3D high\u2010resolution <jats:styled-content style=\"fixed-case\">ARM<\/jats:styled-content> in addition to the <jats:styled-content style=\"fixed-case\">ROME<\/jats:styled-content> III constipation module and the Pelvic Floor Distress Inventory 20 (<jats:styled-content style=\"fixed-case\">PFDI<\/jats:styled-content>\u201020) questionnaires. We analyzed univariate, sex\u2010specific differences in <jats:styled-content style=\"fixed-case\">ARM<\/jats:styled-content> physiologic parameters and <jats:styled-content style=\"fixed-case\">PFDI<\/jats:styled-content>\u201020 parameters and adjusted for putative confounders using multivariate logistic regression.<\/jats:p><\/jats:sec><jats:sec><jats:title>Key Results<\/jats:title><jats:p>Our study enrolled 80 men and 165 age\u2010matched women. Men had a higher median sphincter resting pressure (81.2 vs 75.2\u00a0mm Hg, <jats:italic>P<\/jats:italic>=.01) and mean squeeze pressure (257.0 vs 170.5\u00a0mm Hg, <jats:italic>P<\/jats:italic>&lt;.0001) than women. Although men reported significantly less severe straining and incomplete evacuation, they had greater mean rectoanal pressure differential (\u2212106.7 vs \u221271.1\u00a0mm Hg, <jats:italic>P<\/jats:italic>&lt;.0001), smaller mean defecation index (0.17 vs 0.27, <jats:italic>P<\/jats:italic>=.03) and higher volume threshold for urgency (115.2 v. 103.4\u00a0mL, <jats:italic>P<\/jats:italic>=.03). However, women were more likely to have abnormal balloon expulsion time (<jats:styled-content style=\"fixed-case\">BET<\/jats:styled-content>) than men (52.7% vs 35.0%, <jats:italic>P<\/jats:italic>=.01). After multivariate analysis, male gender was the only independent predictor of a normal <jats:styled-content style=\"fixed-case\">BET<\/jats:styled-content> (<jats:styled-content style=\"fixed-case\">OR<\/jats:styled-content>: 0.48, 95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>: 0.27\u20100.86, <jats:italic>P<\/jats:italic>=.01).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions &amp; Inferences<\/jats:title><jats:p>Men and women with <jats:styled-content style=\"fixed-case\">CC<\/jats:styled-content> differ with regard to symptom severity and physiologic parameters derived from <jats:styled-content style=\"fixed-case\">ARM<\/jats:styled-content> suggesting differences in their pathophysiology.<\/jats:p><\/jats:sec>","DOI":"10.1111\/nmo.12980","type":"journal-article","created":{"date-parts":[[2016,11,28]],"date-time":"2016-11-28T02:46:51Z","timestamp":1480301211000},"source":"Crossref","is-referenced-by-count":25,"title":["Gender differences in chronic 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USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A.","family":"Lembo","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology Department of Medicine Beth Israel Deaconess Medical Center  Boston MA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"K.","family":"Staller","sequence":"additional","affiliation":[{"name":"Center for Neurointestinal Health and Division of Gastroenterology Massachusetts General Hospital  Boston MA 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