Do you have bloating? Heartburn? Stomach pain? Jonathan Schreiber, MD, gastroenterologist at Mercy Medical Center in Baltimore and clinical assistant professor at the University of Maryland School of Medicine, sheds light on gastrointestinal disorders.
1. Are gastrointestinal or GI conditions different for men and women?
There are definitely some differences, and part of the reason is probably related to basic physiology. One of the most common GI conditions is irritable bowel syndrome, or IBS. For years, we've known more women than men have IBS, though that distinction might have been overplayed because men and women may deal with it differently. A man may just say, "I'm going to tough it out," and a woman may say, "I'm going to go to my doctor and see what's going on." So it looks to the doctor that women have more IBS, but that may not be the case.
Beyond that, there is likely some difference due to the way the muscles work in men and women. Think of the GI tract as a long tube from your mouth all the way down to the rectum, surrounded by muscles that are contracting all the time. Along the way are your stomach and other organs. There are studies suggesting that GI muscle motility is a bit slower in women than in men, and this is even more true when IBS is present.
If the muscles are moving really quickly in people with IBS, they get diarrhea. If the muscles are moving very slowly, they get constipation, and if the muscles are going into a spasm, they get pain. The slow muscle form is very common, but it's much more common in women than in men.
Inflammatory bowel disease, or IBD, is fairly common in both men and women. The bowel lining gets inflamed and damaged, causing abdominal pain, diarrhea, and sometimes bleeding. Doctors think the two types of IBD -- Crohn's disease and ulcerative colitis -- are autoimmune diseases. You're probably born with some sort of a genetic predisposition, and then something triggers an immune reaction -- whether it's some unusual infection or something dietary, we just don't know.
2. Which GI disorders are on the rise?
There's been a recent explosion of GERD, or gastroesophageal reflux disease, and nobody really has a good explanation why. Clearly our diet has something to do with it. We weigh more as a population now than we did five or 10 years ago.
There's also a big uptick in the number of people diagnosed with celiac disease, and it's probably not so much on the rise but just being recognized more. Celiac is an autoimmune condition, meaning your body's immune system is sort of turning against itself. And the trigger for that is gluten, a protein in wheat and many other grains. If you have celiac disease, eating gluten causes your own antibodies to attack your bowel. People of Mediterranean descent and children seem to develop celiac disease more than other people. But what's been recognized recently is older people get it as well, with symptoms like constipation, diarrhea, bloating, and abdominal pain -- all of which look very much like IBS.