Differences in Clinical Manifestations of Inflammatory Bowel Disease Based on Gender

Abstract

Introduction: Inflammatory bowel disease is a disease group with multiple intestinal and extra-intestinal manifestations. It is associated with multiple hepatobiliary and systemic inflammatory conditions. The gender-based differences in clinical manifestations of IBD remains sparsely studied. We evaluated the differences in intestinal and extra-intestinal disease manifestations in IBD patients based on gender. Methods: We studied a cohort of patients presenting to our inflammatory bowel disease clinic in 2013. All patients with histopathological findings of inflammatory bowel disease on colonoscopy were included in the study. Medical records were reviewed for demographic and clinical data. Chi-square test with Yates’ continuity correction and fisher’s exact test were used to evaluate categorical variables and Student’s t-test was used to evaluate continuous variables. Results: Two hundred seventy-five patient records were reviewed, and 257 patients were included in the study. There were 118 male and 139 female patients. Of them, 60 patients had classical extra-intestinal manifestations (blepharitis/iritis/scleritis/uveitis, primary sclerosing cholangitis, pyoderma gangreonosum, oligoarthropathies/arthritis, ankylosing spondylitis, autoimmune hepatitis), while 78 patients had associated systemic disorders (hypothyroidism, asthma, pulmonary fibrosis, allergic rhinitis, rheumatoid arthritis, sarcoidosis, osteoporosis, psoriasis). Some patients had multiple manifestations. Mood disorders were present in 22.48% of patients. In our cohort, there was a higher prevalence of extra-intestinal disorders associated with IBD and mood disorders in female patients. There was no difference in the severity of IBD or the prevalence of classical extra-intestinal manifestations of IBD. Conclusion: Our study showed increased prevalence of extra-intestinal diseases and mood disorders in female IBD patients. This is consistent with the current understanding that women in general have a higher prevalence of auto-inflammatory diseases. However, there was no statistical difference on the severity of intestinal disease or need for surgery. The gender-based differences in disease manifestations should be considered while treating patients with IBD.Table 1: Difference in IBD manifestation by gender