Research indicates that gastrointestinal (GI) distress is more than twice as common in women as in men.
This difference in GI problems between the sexes extends to the function of their gastrointestinal tract, commonly known as the "gut," along with differences in their hormones and food habits.
"Digestive problems refer to issues that occur with how food is broken down once it is consumed," explained Gastroenterologist William Kolozsi, M.D. "Because the digestive system is a complex function of the body, issues can arise anywhere along the trip that food takes, from consumption to expulsion."
Hormonal Causes of Digestive Problems
Although there are many potential causes of digestive problems, there's a high likelihood that some problems experienced as a woman approaches menopause are linked to the effects of hormonal imbalances.
"The body relies on hormones to regulate its different functions, including digestion," Dr. Kolozsi advised. "For example, during menopause there is a higher level of the cortisol hormone in a woman's body. Cortisol is involved in stress responses and is known to create digestive problems, along with other adverse reactions, like anxiety disorders. In addition, the hormone estrogen inhibits cortisol, and when estrogen is too low, cortisol increases and slows down the release of stomach acid and the emptying of the stomach's contents into the small intestine. This can create digestive symptoms, such as gas, bloating and constipation.
of Digestive Problems:
Bloating and gas
Constipation or diarrhea
A false urge to have a bowel movement
"Women are also twice as likely to develop gallstones because of the effects of the hormones estrogen and progesterone," Dr. Kolozsi said. "Progesterone can slow down the emptying of the gallbladder. Estrogen and progesterone also affect the handling of cholesterol in the body and cause an increase of cholesterol in the gallbladder. Because of the slowed emptying of the gallbladder, as well as the increase of cholesterol, women have a greater chance for the development of gallstones."
There are several other possible causes of digestive problems beyond hormones; such as stress, use of medications, poor food choices (processed or junk foods, lack of fiber, etc.), or not chewing food properly. Additional activities or risk factors can also enhance a person's susceptibility to digestive problems, including smoking, the use of excessive alcohol, inactivity, depression, genetics and age.
Many health care professionals speculate that the higher rate of GI problems in women is due to their dietary differences. The September 2005 Journal of the American Dietetic Association, reported that women had a lower fiber and higher fat intake. The same study also found that constipation affects twice as many women as men.
Even the way that food is handled can be different between the sexes. For example, women seem to have a slower emptying of food from their stomachs, but this difference starts to disappear as they age. Besides affecting how food is broken down, the slower metabolism by the enzymes in the small intestine and in the liver can also affect how effectively women break down medications.
Other Common GI Problems in Women
Inflammation of the Stomach (Gastritis): For pain relief, many women use aspirin or NSAIDs (non-steroidal anti-inflammatory drugs). "These drugs, when used for a long time, are known to cause irritation to the stomach lining and may lead to bleeding from the stomach," Dr. Kolozsi advised. "Women who use NSAIDs chronically are at a higher risk for developing stomach ulcers as well as gastritis. NSAIDs may also can decrease the level of mucus that the stomach normally makes to protect itself."
Hemorrhoids: Hemorrhoids are veins in the anal canal that can become swollen or stretched, and develop in about half of Americans by age 50. Hemorrhoids develop due to increased pressure often caused by straining to have a bowel movement, and they frequently develop in women during pregnancy. Chronic constipation, diarrhea, hereditary factors, and aging may also lead to hemorrhoids.
Irritable Bowel Syndrome (IBS): Irritable Bowel Syndrome occurs two to six times more often in women than in men. One reason for this may be that women are normally more sensitive to irritants of the GI tract, such as increased gas in the gut. "If a woman has IBS, combined with some emotional stress, the gut becomes somewhat hyperactive and she may experience either diarrhea, constipation, or both," Dr. Kolozsi continued.
Colon Disorders: Inflammatory Bowel Disease (IBD) occurs more often in women than men at a rate of 2:1; and is primarily made up of two conditions: Crohn's Disease (inflammation of intestinal wall) and Ulcerative Colitis (inflammation of colon's lining).
Colon Cancer: Some women aged 55 or younger have a higher frequency of colon cancer and are advised to follow current American Cancer Society guidelines and be screened at age 50; and to talk to their doctors if they have a family history of the disease, which means they should be screened at an earlier age.
"It is important to understand these differences between men and women, because many diseases of the GI tract can be prevented or minimized by maintaining a healthy lifestyle," Dr. Kolozsi concluded.
Wiliam Z. Kolozsi, M.D., is a gastroenterologist affiliated with Salem Community Hospital's activemedical Staff. His office is located at The Gastroenterology Center, 2020 East State Street, Suite H, in Salem 330-337-8709.