The incidence and prevalence of inflammatory bowel disease (IBD) including Crohn's disease
(CD), ulcerative colitis (UC), and inflammatory bowel disease undetermined (IBDU) are rising
globally (1,2). Gender differences in IBD have been increasingly recognized, reflecting distinct
patterns in disease presentation, progression, and management between men and women. In our
study, we analyzed epidemiological data from the Swiss IBD cohort study (SIBDCS) to explore
these gender-specific differences. We found that CD and IBDU are more prevalent in women,
while UC is more common in men. Women with IBD, particularly those with CD, are more
likely to smoke and experience higher levels of anxiety and depression, which may contribute
to delayed diagnosis and increased disease burden (3). Diagnosis delays were more pronounced
in women, particularly those with CD, highlighting potential issues in healthcare follow-up and
due to atypical disease presentations and misdiagnoses linked to functional gastrointestinal or
gynecological disorders (4). Moreover, women are less likely to undergo surgery or receive
immunomodulators and biological treatments, particularly after the age of 55, compared to men,
according to Lungaro et al. (3). This discrepancy may stem from medical biases and concerns
about the impact of these treatments on fertility and pregnancy (5). Additionally, women have
a lower body mass index (BMI) than men, which may influence the course and treatment of the
disease. Disease severity also differed by gender; men were more likely to experience severe
complications such as strictures and fistulas in CD, and pancolitis in UC, leading to a higher
frequency of surgical interventions. Additionally, extraintestinal manifestations (EIMs) were
more common in women, while men were more often affected by serious conditions like
primary sclerosing cholangitis (PSC). These findings underscore the importance for
gastroenterologists to consider gender-specific factors when diagnosing and treating IBD,
aiming to improve patient outcomes through more personalized care approaches.