Published online Dec 7, 2017. doi: 10.3748/wjg.v23.i45.8053
Peer-review started: August 5, 2017
First decision: September 13, 2017
Revised: September 27, 2017
Accepted: November 8, 2017
Article in press: November 8, 2017
Published online: December 7, 2017
Processing time: 122 Days and 21.2 Hours
Although gender is assumed to be an important factor in the pathogenesis, progression and prognosis of certain diseases, there have been only a few reported gender differences in functional gastrointestinal disorders, and attention has focused mostly on irritable bowel syndrome.
Most functional gastrointestinal disorders, including functional dyspepsia, show female predominance.
We compared the possible etiological factors including ghrelin, nociception-related genes, psychological aspects and history of abdominal operation as well as basal characteristics, dyspepsia symptoms and quality of life between male and female functional dyspepsia patients.
Total of 191 persons [87 subjects (male 38, female 49) and 104 patients (male 39, female 65)] were prospectively enrolled between March 2013 and May 2016 in Seoul National Bundang Hospital. They were classified into control and FD group (PDS, EPS and mixed subgroups) on the basis of ROME III criteria. Questionnaire included assessment for dyspepsia symptoms, quality of life by WHOQOL-BREF scores and anxiety or depression by HADS scores were analyzed. Preproghrelin and nociception genes were analyzed by RT-PCR from the gastric mucosa. Plasma acyl/des-acyl ghrelin were measured by ELISA method.
Differences in plasma acyl ghrelin and the gastric expressions of most nociception-related gene between dyspepsia and control groups were significant only in men. In contrast, female functional dyspepsia patients had a more anxious and depressive mood, and showed a more apparent impaired quality of life compared to male dyspeptic patients. Epigastric burning or pain was correlated with anxiety score only in women. Women who underwent any gynecologic surgery showed more severe overall abdominal symptoms than women who did not.
Different mechanisms might underlie the perception of dyspeptic symptom by gender and the negative impact of the functional dyspepsia on the quality of life can be more prominent in women than men.
More careful assessment of psychological or emotional status is required particularly for the female FD patients.