THere’s the hidden gender gap when it comes to digestive issues, with women taking the lead in this nasty competition. While men are hardly immune to gastrointestinal problems, some digestive issues are significantly more common in women. “Women aren’t broken — they’re just different,” says Dr. Jeanette Fry, a gastroenterologist at the University of Virginia in Charlottesville. For one thing, she says, “women have more visceral hypersensitivity, so they may feel gastrointestinal symptoms more intensely.”
Beyond sensitivity to symptoms, there’s clear evidence that some digestive disorders affect women more often than men. Irritable bowel syndrome (IBS), a disorder that involves recurring bouts of abdominal pain and changes in bowel habits (diarrhea, constipation, or alternating between the two), is two to six times more common in women than in men. Inflammatory bowel disease (IBD), including Crohn’s disease and ulcerative colitis, affects twice as many women as men, according to the American College of Gastroenterology.
Additionally, celiac disease—an autoimmune disorder that causes bloating, chronic diarrhea, constipation, gas, and other gastrointestinal symptoms triggered by gluten consumption—is diagnosed in women nearly twice as often as in men. And functional dyspepsia (aka chronic indigestion) is also more common in women. So is a lesser-known brain-gut disorder called cyclic vomiting syndrome—characterized by repeated episodes of nausea, vomiting, and dry heaving, separated by symptom-free periods in between, says David Levinthal, MD, a gastroenterologist and director of the Center for Neurogastroenterology and Motility at the University of Pittsburgh Medical Center.
In general, “gut-brain interaction disorders are more common in women than in men,” Levinthal says, and the same goes for motility disorders such as gastroparesis (delayed stomach emptying) and chronic constipation.
The Mysterious Gender Gap
Why are women more susceptible to gastrointestinal problems? What is it about being born as a woman that puts her digestive system at risk? The answer is complex and not fully understood.
What is known: Reproductive hormones may play a role. “The female hormones estrogen and progesterone have profound effects on the GI tract in terms of motility, pain sensitivity, and how the brain delivers messages to the GI tract,” explains David Johnson, MD, chief of gastroenterology at Eastern Virginia Medical School in Norfolk and former president of the American College of Gastroenterology. As a result, women may experience flare-ups of GI distress at certain times of the month (like during their period) or during pregnancy.
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Second, “women have a more easily activated immune system than men,” Levinthal says. That’s important because immune function, including inflammation, plays a role in celiac disease and inflammatory bowel disease.
What’s more, women’s GI tracts are longer, and that difference in length may affect transit time, Johnson says. Women’s stomachs also empty slightly more slowly than men’s—“why this is is unknown,” Levinthal says, but it may explain why women are more susceptible to gastroparesis. Research also shows that gut nerve cells are more sluggish in women, which may be why IBS and gastroparesis are more common in women.
Another possible contributing factor has to do with psychological issues. “Anxiety and depression, which are more common in women than men, can make bowel dysfunction worse,” says Levinthal. “Feeling stressed, depressed, or anxious is related to how our gut is functioning.” When you’re stressed or anxious, you may be more likely to experience a flare-up of these GI disorders.
Give your gut the right care
Regardless of gender, it’s important to “do everything you can to be proactive about your digestive health, not just reactive,” says Johnson. That means staying hydrated and eating a healthy diet rich in plant-based foods (fruits, vegetables, whole grains, legumes, nuts, and seeds) and lean protein, and avoiding sugary, highly processed foods.
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Specifically, “fiber helps good bacteria thrive in the gut,” Johnson says, which promotes the health of the gut microbiome, the community of bacteria and other microbes that naturally live in the gastrointestinal tract. Research has found a strong correlation between gut bacteria and the risk of GI disorders like IBS, IBD, and others.
Being proactive about your gut health also means taking steps to manage stress, getting enough sleep, and exercising regularly. “The more you move your body, the more your gut moves,” says Dr. Samuel Akinie, a gastroenterologist at The Ohio State University Wexner Medical Center. That kind of movement is likely to help with many of these disorders.
If these measures don’t help enough, there’s no point in suffering alone. Medications and other treatments are available for all of these digestive disorders. “If you have symptoms you don’t understand, see a gastroenterologist,” advises Fry. “Many women are embarrassed to talk about their GI symptoms—I want them to feel empowered to discuss them. I tell my patients this is a safe place, and I’m not ashamed to hear anything. That’s why I’m here.”