This is in large part because of the role of estrogens and progesterones during and following pregnancy and throughout women s lives. Recent research has identified defects in specific enzymes in lipid metabolism that predispose to gallstone disease in experimental animals. These include alterations in key enzymes that allow cholesterol to be excreted by the liver. Women are affected twice as often as men. Functional bowel disorders are associated with a history of physical and sexual abuse.
Affected individuals have chronic abdominal pain, changes in bowel habits, gas and bloating.
Although these disorders do not cause substantial mortality, they are a major cause of morbidity and health care costs, both direct and as a consequence of decreased productivity. Recent clinical trials targeted at pain control, such as serotonin antagonists, show promise in ameliorating symptoms. Clinical trials of the gonadotrophin-releasing hormone analog leuprolide show promise for new treatment approaches. Further research into their mechanism of action is likely to provide insights into the gender differences in irritable bowel syndrome. Because even modest decreases in weight can substantially decrease the risk of medical complications such as hypertension, cardiovascular disease, and diabetes, the role of pharmacological anti-obesity agents is an active area of research.