Abstract

Sex (the physical and physiologic effects resulting from having specific combinations of sex chromosomes) and gender (sex-associated behaviours, expectations, identities, and roles) significantly affect the course of inflammatory bowel disease (IBD) and the experience of living with IBD. Sex-influenced physiologic states, like puberty, the menstrual cycle, pregnancy, and andropause/menopause may also impact and be impacted by IBD.

While neither Crohn’s disease nor ulcerative colitis is commonly considered sex-determined illnesses, the relative incidence of Crohn’s disease and ulcerative colitis between males and females varies over the life cycle. In terms of gender, women tend to use healthcare resources at slightly higher rates than men and are more likely to have fragmented care. Women are more commonly prescribed opioid medications and are less likely than men to undergo colectomy. Women tend to report lower quality of life and have higher indirect costs due to higher rates of disability. Women are also more likely to take on caregiver roles for children with IBD. Women with IBD are more commonly burdened with adverse mental health concerns and having poor mental health has a more profound impact on women than men.

Pregnant people with active IBD have higher rates of adverse outcomes in pregnancy, made worse in regions with poor access to IBD specialist care. The majority of individuals with IBD in Canada do not have access to a pregnancy-in-IBD specialist; access to this type of care has been shown to allay fears and increase knowledge among pregnant people with IBD.

Details

Title
The 2023 Impact of Inflammatory Bowel Disease in Canada: The Influence of Sex and Gender on Canadians Living With Inflammatory Bowel Disease
Author
Targownik, Laura E 1 ; Bollegala, Natasha 2 ; Huang, Vivian W 1 ; Windsor, Joseph W 3 ; Kuenzig, M Ellen 4 ; Benchimol, Eric I 4 ; Kaplan, Gilaad G 3 ; Murthy, Sanjay K 5 ; Bitton, Alain 6 ; Bernstein, Charles N 7 ; Jones, Jennifer L 8 ; Lee, Kate 9 ; Peña-Sánchez, Juan-Nicolás 10 ; Rohatinsky, Noelle 11 ; Ghandeharian, Sara 9 ; Davis, Tal 4 ; Weinstein, Jake 4 ; Im, James H B 4 ; Jannati, Nazanin 10 ; Khan, Rabia 4 ; Matthews, Priscilla 12 ; Tyrel Jones May 13 ; Tabatabavakili, Sahar 14 ; Jogendran, Rohit 15 ; Hazan, Elias 16 ; Browne, Mira 4 ; Meka, Saketh 16 ; Vukovic, Sonya 16 ; Jogendran, Manisha 17 ; Hu, Malini 14 ; Jessica Amankwah Osei 10 ; Wang, Grace Y 15 ; Tasbeen Akhtar Sheekha 10 ; Dahlwi, Ghaida 18 ; Goddard, Quinn 3 ; Gorospe, Julia 3 ; Nisbett, Cyanne 19 ; Gertsman, Shira 20 ; Sousa, James 9 ; Taylor Morganstein 21 ; Stocks, Taylor 9 ; Weber, Ann 22 ; Seow, Cynthia H 3 

 Division of Gastroenterology and Hepatology, Mount Sinai Hospital, University of Toronto , Toronto, Ontario , Canada 
 Department of Gastroenterology, Women’s College Hospital , Toronto, Ontario , Canada 
 Departments of Medicine and Community Health Sciences, University of Calgary , Calgary, Alberta , Canada 
 SickKids Inflammatory Bowel Disease Centre, Division of Gastroenterology, Hepatology, and Nutrition, The Hospital for Sick Children , Toronto, Ontario , Canada 
 Department of Medicine, University of Ottawa , Ottawa, Ontario , Canada 
 Division of Gastroenterology and Hepatology, McGill University Health Centre IBD Centre, McGill University , Montréal, Quebec , Canada 
 Department of Internal Medicine, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba , Winnipeg, Manitoba , Canada 
 Departments of Medicine, Clinical Health, and Epidemiology, Dalhousie University , Halifax, Nova Scotia , Canada 
 Crohn’s and Colitis Canada , Toronto, Ontario , Canada 
10  Department of Community Health and Epidemiology, University of Saskatchewan , Saskatoon, Saskatchewan , Canada 
11  College of Nursing, University of Saskatchewan , Saskatoon, Saskatchewan , Canada 
12  Department of Medicine, McMaster University , Hamilton, Ontario , Canada 
13  Division of Gastroenterology and Hepatology, University Health Network, University of Toronto , Toronto, Ontario , Canada 
14  Department of Gastroenterology, Temerty Faculty of Medicine, University of Toronto , Toronto, Ontario , Canada 
15  Department of Medicine, Temerty Faculty of Medicine, University of Toronto , Toronto, Ontario , Canada 
16  Department of Internal Medicine, Temerty Faculty of Medicine, University of Toronto , Toronto, Ontario , Canada 
17  Department of Medicine, Queen’s University , Kingston, Ontario , Canada 
18  Division of Gastroenterology, Hepatology, and Nutrition, The Hospital for Sick Children, University of Toronto , Toronto , Canada 
19  Faculty of Law, University of Victoria , Victoria, British Colombia , Canada 
20  Michael G. DeGroote School of Medicine, McMaster University , Hamilton, Ontario , Canada 
21  Faculty of Medicine and Health Sciences, McGill University , Montreal, Quebec , Canada 
22  Department of Obstetrics and Gynecology, Memorial University of Newfoundland , St. John’s, Newfoundland , Canada 
Pages
S55-S63
Publication year
2023
Publication date
Sep 2023
Publisher
Oxford University Press
ISSN
25152084
e-ISSN
25152092
Source type
Scholarly Journal
Language of publication
English
ProQuest document ID
3168645766
Copyright
© The Author(s) 2023. Published by Oxford University Press on behalf of the Canadian Association of Gastroenterology. This work is published under https://creativecommons.org/licenses/by/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.