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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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“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]
In the citing paper
“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]
In the citing paper
“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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“Over a 7-day period, participants underwent CTT assessments using a validated radiopaque marker method (19), submitted stool samples for SCFA and BA quantification by high-performance liquid chromatography, and completed4-day fooddiaries (seeAppendix, SupplementaryDigital Content 1, http://links.”
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Self-citationColon transit time in healthy children and adolescents
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“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
“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
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
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
Andersson, S., Ringström, G., Elfvin, A., et al. (2010) · Digestion · doi:10.1159/000291905 · Cited by 24
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
Vulcan, A., Manjer, J., Ericson, U., & Ohlsson, B. (2017) · Food & Nutrition Research · doi:10.1080/16546628.2017.1341810 · Cited by 23
“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
Sex differences of brain and their implications for personalized therapy
Rezzani, R., Franco, C., & Rodella, L. F. (2019) · Pharmacological Research · doi:10.1016/j.phrs.2019.01.030 · Cited by 24
Sex-dependent modulation of treatment response
Rubinow, D. R., & Moore, M. (2004) · Dialogues in Clinical Neuroscience · doi:10.31887/dcns.2004.6.1/drubinow · Cited by 23
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 23
“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
“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
Sex-Related Differences in Chronic Pain: A Narrative Review by a Multidisciplinary Task Force
Marchesini, M., Fornasari, D., Natoli, S., Vegni, E. A. M., & Cuomo, A. (2025) · Medicina · doi:10.3390/medicina61071172 · Cited by 24
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
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
“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
“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
Metadata
- 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 › Urology › 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
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