Gender Differences in Gut Transit Shown with a Newly Developed Radiological Procedure
Abstract
BACKGROUND: Gut transit measurements are essential for understanding the pathophysiology of many gastrointestinal disorders. The ideal bowel transit test should be easy to perform, widely accessible, reproducible, non-invasive and inexpensive and the risks should be minimal. These requirements prompted us to develop a procedure for simultaneous measurement of gastric emptying, small-bowel transit and colonic transit at one visit. We assessed the influence of gender, body mass index, age, menopause and smoking on gastrointestinal transit in healthy subjects. METHODS: Eighty-three healthy subjects (43 women) were included. Colonic transit was based on 10 radiopaque rings given daily for 6 days with fluoroscopy on day 7. Then, the subjects had a test meal containing 20 radiopaque markers. Using fluoroscopy, gastric emptying and small-bowel transit of the markers were followed until they reached the colon. RESULTS: Gastric emptying, small-bowel transit and colonic transit were significantly slower in female healthy subjects compared to males (2.9 (1.6-4.9) h, median and percentile 10-90, versus 2.4 (0.7-3.7) h, P=0.005; 4.4 (2.1-11.1) h versus 3.2 (1.5-6.0) h, P=0.001; 1.5 (1.0-3.7) days versus 1.3 (0.8-1.9) days P=0.002), respectively. Small-bowel transit was significantly faster in women with overweight and in postmenopausal women compared to lean and premenopausal women, respectively. CONCLUSION: This procedure meets most of the requirements of the ideal bowel transit test and is easily performed at one visit. Small-bowel transit as well as gastric emptying and colonic transit were significantly slower for women.
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The increase in percentage of total energy from CHO oxidation in women was not attributable to a higher percentage of exogenous carbohydrate oxidation but to a smaller decrease in endogenous CHO oxidation in eumenorrheic women during exercise.
“This increase was not attributable to a higher percentage of exogenous carbohydrate oxidation, but, alternatively, was attributed to a smaller decrease in endogenous CHO oxidation in eumenorrheic women during exercise [201].”
From International society of sports nutrition position stand: nutritional concerns of the female athlete (2023) · cites this paper as [201]
It has not been established if multiple transportable carbohydrate blends at high doses (up to 90 g/h) improve peak exogenous oxidation rates in females.
“it has not been established if multiple transportable carbohydrate blends at high doses (up to 90 g · h−1) improve peak exogenous oxidation rates in females [201,211].”
From International society of sports nutrition position stand: nutritional concerns of the female athlete (2023) · cites this paper as [201]
Women using COC demonstrate a slightly lower reliance on exogenous CHO oxidation compared to non-COC users.
“Women using COC demonstrate a slightly lower reliance on exogenous CHO oxidation as compared to non-COC users [98,179,201].”
From International society of sports nutrition position stand: nutritional concerns of the female athlete (2023) · cites this paper as [201]
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Borg, J., Simrén, M., & Ohlsson, B. (2011) · Neurogastroenterology & Motility · doi:10.1111/j.1365-2982.2010.01599.x · Cited by 26 · see citing works
Bach, T., Galbiati, S., Kennedy, J. K., et al. (2020) · Antimicrobial Agents and Chemotherapy · doi:10.1128/aac.01018-20 · Cited by 26 · see citing works
Effects of female steroid hormones on A‐type K+currents in murine colon
Beckett, E. A. H., McCloskey, C., O'Kane, N., Sanders, K. M., & Koh, S. D. (2006) · The Journal of Physiology · doi:10.1113/jphysiol.2006.107375 · Cited by 25 · see citing works
“Previous clinical studies (Lawson et al. 1985; Hutson et al. 1989; Baron et al. 1993; Meier et al. 1995; Bond et al. 1996; Jung et al. 2003; Sadik et al. 2003) and in vivo and in vitro animal experiments (Ryan & Bhojwani, 1986; Chen et al.”
ResultGut Transit in Celiac Disease: Delay of Small Bowel Transit and Acceleration after Dietary Treatment
Sadik, R., Abrahamsson, H., Kilander, A. F., et al. (2004) · The American Journal of Gastroenterology · doi:10.1111/j.1572-0241.2004.40406.x · Cited by 26 · see citing works
“For colonic transit measurements the patients ingested 10 radiopaque rings daily for 6 days (8, 9, 13).”
BackgroundMethodResultInfluentialSelf-citationGhoshal, U., Sengar, V., & Srivastava, D. (2012) · Journal of Neurogastroenterology and Motility · doi:10.5056/jnm.2012.18.2.227 · Cited by 26 · see citing works
Imaging and clinical assessment of functional defecatory disorders with emphasis on defecography
Lalwani, N., Sayed, R. F. E., Kamath, A., Lewis, S. C., Arif, H., & Chernyak, V. (2019) · Abdominal Radiology · doi:10.1007/s00261-019-02142-9 · Cited by 24 · see citing works
Clark, G., Strachan, J. A., McPherson, A., Digby, J., Mowat, C., Steele, R. J., & Fraser, C. G. (2020) · Clinical Chemistry and Laboratory Medicine (CCLM) · doi:10.1515/cclm-2020-0268 · Cited by 24 · see citing works
Andersson, S., Ringström, G., Elfvin, A., et al. (2010) · Digestion · doi:10.1159/000291905 · Cited by 24 · see citing works
Self-citationA future for faecal haemoglobin measurements in the medical laboratory
Fraser, C. G. (2012) · Annals of Clinical Biochemistry International Journal of Laboratory Medicine · doi:10.1258/acb.2012.012065 · Cited by 23 · see citing works
Vulcan, A., Manjer, J., Ericson, U., & Ohlsson, B. (2017) · Food & Nutrition Research · doi:10.1080/16546628.2017.1341810 · Cited by 23 · see citing works
“The prolonged gastrointestinal transit time in women compared with men may lead to a prolonged exposure of the mucosa to carcinogens [28].”
BackgroundInterpretation of overall colonic transit in defecation disorders in males and females
Shin, A., Camilleri, M., Nadeau, A. M., Nullens, S., Rhee, P., Jeong, I. D., & Burton, D. D. (2013) · Neurogastroenterology & Motility · doi:10.1111/nmo.12095 · Cited by 23 · see citing works
Sex differences of brain and their implications for personalized therapy
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Sex-dependent modulation of treatment response
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Glucagon-like peptide (GLP)-1 regulation of lipid and lipoprotein metabolism
HOFFMAN, S. S., & Adeli, K. (2024) · Medical Review · doi:10.1515/mr-2024-0011 · Cited by 22 · see citing works
“However, the initial peak in GLP-1 ’ s biphasic secretion is likely mediated not by direct nutrient contact but via a more rapid mechanism such as neural signaling, since the majority of intestinal L-cells are located in the distal ileum, and small intestinal transit time can exceed 3 h [17, 18].”
Backgroundvan Giersbergen, P. L. M., & Dingemanse, J. (2007) · The Journal of Clinical Pharmacology · doi:10.1177/0091270007305298 · Cited by 21 · see citing works
“As for the effect of food on the tmax of miglustat, the effect of gender may possibly be explained by a difference in gastric emptying time, which is longer in women.(20,21) The observed gender difference in tmax is not considered clinically relevant because miglustat is indicated for the treatment of a chronic condit…”
BackgroundSex, age, and genetics in anesthesia
Booij, L. H. (2008) · Current Opinion in Anaesthesiology · doi:10.1097/aco.0b013e3283007ea3 · Cited by 21 · see citing works
Sex-Related Differences in Chronic Pain: A Narrative Review by a Multidisciplinary Task Force
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Faecal Occult Blood Testing for Colorectal Cancer Screening: the Past or the Future
Benton, S. C., Seaman, H. E., & Halloran, S. P. (2015) · Current Gastroenterology Reports · doi:10.1007/s11894-015-0428-2 · Cited by 21 · see citing works
Kalaitzakis, E., Josefsson, A., Castedal, M., Henfridsson, P., Bengtsson, M., Andersson, B. A., & Bjornsson, E. S. (2013) · Scandinavian Journal of Gastroenterology · doi:10.3109/00365521.2013.836755 · Cited by 20 · see citing works
“Gut transit has been reported to be slower in women compared to men [34] and visceral sensitivity to be influenced by ovarian hormones [15,18].”
BackgroundBajor, A., Kilander, A. F., Sjövall, H., Rudling, M., & Ung, K. (2008) · Digestive Diseases and Sciences · doi:10.1007/s10620-008-0256-4 · Cited by 20 · see citing works
“A high BMI has been shown to be correlated to a more rapid transit [24, 25 ], and subjects with severe overweight also have a higher bile acid synthesis rate [26].”
Background
- Authors
- Sadik, R., Abrahamsson, H., & Stotzer, P.-O.
- Affiliations
- Sahlgrenska University Hospital (SE)
- ORCID
- Sadik, R.
- Venue
- Scandinavian Journal of Gastroenterology
- Publisher
- Informa UK Limited
- Published
- 2003-01
- Volume
- 38
- Issue
- 1
- Pages
- 36-42
- ISSN
- 0036-5521 (ISSN-L)
- 1502-7708
- OpenAlex
- W2041872557
- Cited by
- 183
- References
- 0
- Citations by year
- 2026: 7 · 2025: 5 · 2024: 6 · 2023: 8 · 2022: 7 · 2021: 14 · 2020: 10 · 2019: 13 · 2018: 7 · 2017: 6 · 2016: 5 · 2015: 8 · 2014: 7 · 2013: 10 · 2012: 12
- FWCI
- 3.95
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Scandinavian Journal of Gastroenterology (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Eli Lilly and Company
- Vetenskapsrådet
- Topics
- Health Sciences › Medicine › Gastroenterology › Gastrointestinal motility and disorders
- Health Sciences › Medicine › Rheumatology › Pelvic floor disorders treatments
- Health Sciences › Medicine › Surgery › Enhanced Recovery After Surgery
- Keywords
- gastrointestinal transit, gender differences, gastric emptying, small intestinal transit, colonic transit, radiopaque markers, fluoroscopy, menopause, body mass index, smoking, healthy volunteers
- MeSH terms
- Adolescent, Adult, Age Factors, Aged, Colon, Digestive System, Digestive System Physiological Phenomena, Female, Fluoroscopy, Gastric Emptying, Gastrointestinal Transit, Humans, Intestine, Small, Male, Menopause, Middle Aged, Sex Factors, Body Mass Index
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
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