IBS symptoms in men

IBS is common amongst both men and women, but do the symptoms of IBS in men differ? 

This post will discuss why some IBS symptoms may be more prevalent in men than women and why.

What is IBS?

The British Society of Gastroenterology classes IBS as a disorder between the gut-brain axis. This means that there is a disruption between the communication of the gut and brain that results in IBS symptoms. 

Prevalence of IBS in men

One large review found that there was a lower prevalence of 8.8% in men, in comparison to 10.2% in women (1).

However, it is difficult to know the exact prevalence of IBS in men. This is because:

• Prevalence rates differ depending on the country, due to social and cultural differences.
• Studies collect data in different ways, therefore some studies will get different results even in the same population.
• Data on prevalence relies on people being able or willing to access healthcare. For example, primary care consultation rates amongst men in the UK have been shown to be 32% lower than in women (2). 

Risk factors of IBS in men

The risk factors for IBS in men are the same as for IBS in women. Some of the risk factors are:

• Family history 
• Anxiety/mental health 
• Age
• Poor sleep
• Gut/stomach infection
• Antibiotic use

It is possible that some of the risk factors above may be more common in women than men. This would therefore influence the prevalence of IBS.

Diagnosis of IBS in men

The diagnosis of IBS is the same as in women. Although men may be less likely to seek a diagnosis.

Click here to see how to get an official IBS diagnosis.

Are symptoms of IBS different in men than in women?

Both men and women can experience the same IBS symptoms. However, some differences in the rate of certain IBS symptoms in men and women have been reported. This will be discussed below. 

Constipation

Constipation can be a result of reduced gut motility. If stools are hard for more than 25% of the time, this is classed as IBS-C.

Women are more likely to have the IBS-C subtype than men (3).

Diarrhoea

Diarrhoea can be a result of increased gut motility. If stools are loose for more than 25% of the time, then this is classed as IBS-D. 

IBS-D is the more common subtype in men than women.  However, women are more likely to develop post-infectious IBS than men, where diarrhoea is a common symptom (3).

Bloating

Bloating is caused by the release of gasses produced by gut bacteria in the large bowel. 

Some people with IBS have excess gas production. On top, they may also have reduced gut motility, meaning these gasses can become trapped.

Men are less likely to experience bloating and distension from gasses than women (6). This can be explained by the fact that men have stronger, more developed abdominal walls. 

In addition, bloating often coexists with constipation, which is more common in females.

Stomach pain

People with IBS can have visceral hypersensitivity, meaning their gut is more sensitive. For example, they may experience pain from gas production in amounts that somebody with IBS would not feel the same pain.

Men are less likely to experience visceral hypersensitivity than women, therefore experience less stomach pain (3).

You can read more about the symptoms and causes of IBS here.

Why are there differences in IBS symptoms in men?

There is still a lot of unknown when it comes to the exact causes of IBS. This makes it difficult to know exactly what the differences are between men and women. 

Female sex hormones could negatively influence the following factors (3):

• Stress
• Gut motility 
• Visceral pain
• Gut microbiota

As the above factors play a role in IBS, it makes sense that IBS may be more common in women than males.

There is less data on male sex hormones and IBS risk. However, some research supports that they may have a protective role (3).

How does IBS affect men’s quality of life?

IBS can affect the quality of life due to the persistent and troublesome symptoms that individuals experience. As a result, people with IBS have been shown to have a lower quality of life than those without (4).

One study suggested IBS may reduce the quality of life in women more than men (5). This was related to symptom severity, the more severe the symptoms, the lower the quality of life. This suggests that symptoms may be worse in women but research is limited.

It is important to remember that men may be less likely to seek medical help. This can result in isolation, further increasing anxieties and worsening IBS symptoms. Without the correct help in management, quality of life is likely to further reduce.  

Treatment of IBS in men

The treatment of IBS for men does not differ from the treatment for women. However, men are more likely to have IBS-D than women (3), so it may be that more men are given advice to fit this subtype than women are.

The treatment of IBS is based on your symptoms and IBS subtype rather than your sex. 

When we talk about treatment in IBS, we mean adjusting diet and lifestyle in order to manage symptoms. 

IBS treatment options for men include:

• Dietary changes, such as adjusting intake fibre intake or the low FODMAP diet (under guidance of a Registered Dietitian)
• Increasing physical activity, including yoga
• Psychological therapies, such as CBT and mindfulness 
• Medications, as advised by your GP or Pharmacist

This is something that needs to be considered long-term, as there is no cure for IBS.

Summary

IBS is a disorder between the gut-brain axis that affects both men and women. Some research suggests that it is less prevalent in men.

Much of IBS, such as risk factors, diagnosis and management, is the same in both men and women. However, some symptoms, such as diarrhea, are more common in men. 

Importantly, symptoms may be underreported and more poorly controlled in men. This is due to men being less likely to seek medical help than women are.

Written by Beth Willson Specialist Gastroenterology Dietitian BSc Hons, reviewed by Serena Bansal Registered Dietitian BSc Hons