{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,3]],"date-time":"2026-11-03T18:28:19Z","timestamp":1793730499290,"version":"4.6.1"},"reference-count":83,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2020,1,13]],"date-time":"2020-01-13T00:00:00Z","timestamp":1578873600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["R01\u2010DK115950"],"award-info":[{"award-number":["R01\u2010DK115950"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Neurogastroenterology Motil"],"published-print":{"date-parts":[[2020,7]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>The pathophysiology and mechanisms of irritable bowel syndrome (IBS) involve both central and peripheral mechanisms that result in altered perception, as well as changes in bowel functions. These dysfunctions are associated with motor, sensory, immune, barrier, and intraluminal perturbations, including the microbiota, and their products and endogenous molecules with bioactive properties. There is evidence that these mechanisms are altered in both females and males. However, there is also increasing evidence that sex is a biological variable that impacts a number of aspects of the mechanisms, epidemiology, and manifestations of IBS.<\/jats:p><\/jats:sec><jats:sec><jats:title>Purpose<\/jats:title><jats:p>The objective of this article is to review the evidence of the differences among genders of the following factors in IBS: the brain\u2010gut axis and sex hormones, epidemiology, diagnostic criteria and prognosis, pain perception, colonic transit, abdominal distension, overlap with urogynecological conditions, psychologic issues, anorexia, fibromyalgia, serotonin, and responsiveness to treatment of IBS. It is important to consider the variations attributable to sex in order to enhance the management of patients with IBS and the research of mechanisms involved in IBS.<\/jats:p><\/jats:sec>","DOI":"10.1111\/nmo.13802","type":"journal-article","created":{"date-parts":[[2020,1,14]],"date-time":"2020-01-14T01:45:05Z","timestamp":1578966305000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":52,"title":["Sex as a biological variable in irritable bowel syndrome"],"prefix":"10.1111","volume":"32","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6472-7514","authenticated-orcid":false,"given":"Michael","family":"Camilleri","sequence":"first","affiliation":[{"name":"Division of Gastroenterology and Hepatology Clinical Enteric Neuroscience Translational and Epidemiological Research (C.E.N.T.E.R.) Mayo Clinic Rochester Minnesota"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2020,1,13]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cgh.2012.02.029"},{"key":"e_1_2_9_3_1","first-page":"71","article-title":"The epidemiology of irritable bowel syndrome","volume":"6","author":"Canavan C","year":"2014","journal-title":"Clin Epidemiol"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1111\/apt.15396"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2982.2009.01442.x"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2982.2007.01025.x"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cgh.2008.02.060"},{"issue":"391","key":"e_1_2_9_8_1","first-page":"e2","article-title":"Cumulative effects of psychologic distress, visceral hypersensitivity, and abnormal transit on patient\u2010reported outcomes in irritable bowel syndrome","volume":"157","author":"Simr\u00e9n M","year":"2019","journal-title":"Gastroenterology"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1572-0241.2003.07168.x"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.gastro.2006.05.014"},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.1136\/gut.2006.117390"},{"key":"e_1_2_9_12_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMcp0801447"},{"key":"e_1_2_9_13_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMra1207068"},{"key":"e_1_2_9_14_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMra020995"},{"key":"e_1_2_9_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cgh.2009.10.009"},{"key":"e_1_2_9_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1542-3565(04)00726-8"},{"key":"e_1_2_9_17_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.gastro.2005.09.031"},{"key":"e_1_2_9_18_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.gastro.2019.03.049"},{"key":"e_1_2_9_19_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2982.2010.01498.x"},{"key":"e_1_2_9_20_1","doi-asserted-by":"publisher","DOI":"10.1136\/gutjnl-2017-315136"},{"key":"e_1_2_9_21_1","doi-asserted-by":"publisher","DOI":"10.1007\/BF01303162"},{"key":"e_1_2_9_22_1","doi-asserted-by":"publisher","DOI":"10.1177\/1099800403005001006"},{"key":"e_1_2_9_23_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13030-018-0131-2"},{"key":"e_1_2_9_24_1","doi-asserted-by":"publisher","DOI":"10.1097\/00042737-199703000-00015"},{"key":"e_1_2_9_25_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10620-017-4554-6"},{"key":"e_1_2_9_26_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2982.2004.00581.x"},{"key":"e_1_2_9_27_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.gastro.2007.06.010"},{"key":"e_1_2_9_28_1","doi-asserted-by":"publisher","DOI":"10.1111\/nmo.13483"},{"key":"e_1_2_9_29_1","doi-asserted-by":"publisher","DOI":"10.1097\/00006199-199805000-00006"},{"key":"e_1_2_9_30_1","doi-asserted-by":"publisher","DOI":"10.7326\/0003-4819-113-11-828"},{"key":"e_1_2_9_31_1","doi-asserted-by":"publisher","DOI":"10.1097\/00042737-199704000-00006"},{"key":"e_1_2_9_32_1","doi-asserted-by":"publisher","DOI":"10.1080\/00365529850171819"},{"key":"e_1_2_9_33_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cgh.2011.12.018"},{"key":"e_1_2_9_34_1","doi-asserted-by":"publisher","DOI":"10.1097\/MCG.0000000000001153"},{"key":"e_1_2_9_35_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ynstr.2017.02.003"},{"key":"e_1_2_9_36_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0217610"},{"key":"e_1_2_9_37_1","doi-asserted-by":"publisher","DOI":"10.5056\/jnm18082"},{"key":"e_1_2_9_38_1","doi-asserted-by":"publisher","DOI":"10.3748\/wjg.v20.i22.6725"},{"key":"e_1_2_9_39_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.lfs.2019.116926"},{"key":"e_1_2_9_40_1","doi-asserted-by":"publisher","DOI":"10.1540\/jsmr.45.15"},{"key":"e_1_2_9_41_1","doi-asserted-by":"publisher","DOI":"10.1136\/gut.2004.058685"},{"key":"e_1_2_9_42_1","doi-asserted-by":"publisher","DOI":"10.1016\/0304-3959(91)90094-E"},{"key":"e_1_2_9_43_1","doi-asserted-by":"publisher","DOI":"10.1016\/0022-3999(93)90061-J"},{"key":"e_1_2_9_44_1","doi-asserted-by":"publisher","DOI":"10.1016\/0304-3959(95)00214-6"},{"key":"e_1_2_9_45_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0016-5085(97)70219-1"},{"key":"e_1_2_9_46_1","doi-asserted-by":"publisher","DOI":"10.1097\/00002508-199309000-00004"},{"key":"e_1_2_9_47_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0016-5085(03)00400-1"},{"key":"e_1_2_9_48_1","doi-asserted-by":"publisher","DOI":"10.1136\/gut.39.1.109"},{"key":"e_1_2_9_49_1","doi-asserted-by":"publisher","DOI":"10.1007\/BF01537261"},{"key":"e_1_2_9_50_1","doi-asserted-by":"publisher","DOI":"10.1111\/nmo.12242"},{"key":"e_1_2_9_51_1","doi-asserted-by":"publisher","DOI":"10.1038\/ajg.2012.5"},{"key":"e_1_2_9_52_1","doi-asserted-by":"publisher","DOI":"10.3904\/kjim.2003.18.3.181"},{"key":"e_1_2_9_53_1","first-page":"123","article-title":"Does gender or the menstrual cycle affect colonic transit?","volume":"84","author":"Hinds JP","year":"1989","journal-title":"Am J Gastroenterol"},{"key":"e_1_2_9_54_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2982.2006.00808.x"},{"key":"e_1_2_9_55_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.gastro.2004.12.001"},{"key":"e_1_2_9_56_1","doi-asserted-by":"publisher","DOI":"10.1038\/ajg.2010.408"},{"key":"e_1_2_9_57_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.gastro.2006.07.015"},{"key":"e_1_2_9_58_1","doi-asserted-by":"publisher","DOI":"10.1136\/gut.32.6.662"},{"key":"e_1_2_9_59_1","doi-asserted-by":"publisher","DOI":"10.1016\/0016-5085(93)90896-K"},{"key":"e_1_2_9_60_1","doi-asserted-by":"publisher","DOI":"10.1111\/nmo.13510"},{"key":"e_1_2_9_61_1","doi-asserted-by":"publisher","DOI":"10.1038\/ajg.2010.54"},{"key":"e_1_2_9_62_1","doi-asserted-by":"publisher","DOI":"10.3109\/00365521.2012.661762"},{"key":"e_1_2_9_63_1","first-page":"37","article-title":"Gender differences in irritable bowel syndrome","volume":"5","author":"Chial HJ","year":"2002","journal-title":"J Gend Specif Med"},{"key":"e_1_2_9_64_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1464-410X.2012.11591.x"},{"key":"e_1_2_9_65_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1572-0241.1999.01643.x"},{"key":"e_1_2_9_66_1","doi-asserted-by":"publisher","DOI":"10.1093\/rheumatology\/30.3.220"},{"key":"e_1_2_9_67_1","doi-asserted-by":"publisher","DOI":"10.1055\/s-0038-1676090"},{"key":"e_1_2_9_68_1","doi-asserted-by":"publisher","DOI":"10.1097\/MD.0000000000006657"},{"key":"e_1_2_9_69_1","doi-asserted-by":"publisher","DOI":"10.1038\/ajg.2008.94"},{"key":"e_1_2_9_70_1","doi-asserted-by":"publisher","DOI":"10.1177\/039463200601900408"},{"key":"e_1_2_9_71_1","doi-asserted-by":"publisher","DOI":"10.1159\/000236217"},{"key":"e_1_2_9_72_1","doi-asserted-by":"publisher","DOI":"10.1152\/ajpendo.00484.2005"},{"key":"e_1_2_9_73_1","doi-asserted-by":"publisher","DOI":"10.1073\/pnas.94.10.5308"},{"key":"e_1_2_9_74_1","doi-asserted-by":"publisher","DOI":"10.2169\/internalmedicine.56.7674"},{"key":"e_1_2_9_75_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.gastro.2006.11.020"},{"key":"e_1_2_9_76_1","doi-asserted-by":"publisher","DOI":"10.1152\/ajpgi.00131.2018"},{"key":"e_1_2_9_77_1","doi-asserted-by":"publisher","DOI":"10.1375\/twin.11.2.197"},{"key":"e_1_2_9_78_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.gastro.2018.03.064"},{"key":"e_1_2_9_79_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.psyneuen.2016.03.016"},{"key":"e_1_2_9_80_1","doi-asserted-by":"publisher","DOI":"10.1097\/MEG.0b013e32832b9c53"},{"key":"e_1_2_9_81_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1572-0241.2001.04138.x"},{"key":"e_1_2_9_82_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41395-018-0222-5"},{"key":"e_1_2_9_83_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.gastro.2018.03.063"},{"key":"e_1_2_9_84_1","first-page":"1613","article-title":"Assessing telephone\u2010delivered cognitive\u2010behavioural therapy (CBT) and web\u2010delivered CBT versus treatment as usual in irritable bowel syndrome (ACTIB): a multicentre randomised trial","volume":"68","author":"Everitt HA","year":"2019","journal-title":"Gut"}],"container-title":["Neurogastroenterology &amp; Motility"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1111%2Fnmo.13802","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/nmo.13802","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/nmo.13802","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/nmo.13802","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,9,5]],"date-time":"2023-09-05T10:36:27Z","timestamp":1693910187000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/nmo.13802"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,1,13]]},"references-count":83,"journal-issue":{"issue":"7","published-print":{"date-parts":[[2020,7]]}},"alternative-id":["10.1111\/nmo.13802"],"URL":"https:\/\/doi.org\/10.1111\/nmo.13802","archive":["Portico"],"relation":{},"ISSN":["1350-1925","1365-2982"],"issn-type":[{"value":"1350-1925","type":"print"},{"value":"1365-2982","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,1,13]]},"assertion":[{"value":"2019-11-06","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2019-12-26","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2020-01-13","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e13802"}}