Inflammatory bowel diseases show a gender bias, as reported for several other immune-mediated diseases. Female-specific differences influence disease presentation and activity, leading to a different progression between males and females. Women show a genetic predisposition to develop inflammatory bowel disease related to the X chromosome. Female hormone fluctuation influences gastrointestinal symptoms, pain perception, and the state of active disease at the time of conception could negatively affect the pregnancy. Women with inflammatory bowel disease report a worse quality of life, higher psychological distress, and reduced sexual activity than male patients. This narrative review aims to resume the current knowledge of female-related features in clinical manifestations, development, and therapy, as well as sexual and psychological implications related to inflammatory bowel disease. The final attempt is to provide gastroenterologists with a roadmap of female-specific differences, to improve patients’ diagnosis, management, and treatment.

Crohn’s disease (CD) is a chronic inflammatory bowel disease (IBD) which can affect any part of the whole gastrointestinal tract (from mouth to anus). Malnutrition affects 65–75% of CD patients, and it is now well acknowledged that diet is of paramount importance in the management of the disease. In this review, we would like to highlight the most recent findings in the field of nutrition for the treatment of CD. Our analysis will cover a wide range of topics, from the well-established diets to the new nutritional theories, along with the recent progress in emerging research fields, such as nutrigenomics.

Celiac disease (CD) is an autoimmune disorder caused by gluten ingestion in genetically predisposed individuals. In addition to the typical gastrointestinal symptoms (e.g., diarrhea, bloating, and chronic abdominal pain), CD may also present with a broad spectrum of manifestations, including low bone mineral density (BMD) and osteoporosis. The etiopathology of bone lesions in CD is multifactorial and other conditions, rather than mineral and vitamin D malabsorption, may affect skeletal health, especially those related to the endocrine system. Here, we describe CD-induced osteoporosis in an attempt to enlighten new and less-known aspects, such as the influence of the intestinal microbiome and sex-related differences on bone health. This review describes the role of CD in the development of skeletal alterations to provide physicians with an updated overview on this debated topic and to improve the management of osteoporosis in CD.

Anderson-Fabry disease (FD) is an X-linked lysosomal storage disorder leading to a wide array of clinical manifestations. Among these, gastrointestinal (GI) symptoms such as abdominal pain, bloating, and diarrhea affect about half of the FD adults and more than half of FD children. GI symptoms could be the first manifestation of FD; however, being non-specific, they overlap with the clinical picture of other conditions, such as irritable bowel syndrome and inflammatory bowel disease. This common overlap is the main reason why FD patients are often unrecognized and diagnosis is delayed for many years. The present narrative review is aimed to promote awareness of the GI manifestations of FD amongst general practitioners and specialists and highlight the latest findings of this rare condition including diagnostic tools and therapies. Finally, we will discuss some preliminary data on a patient presenting with GI symptoms who turned to be affected by a variant of uncertain significance of alpha-galactosidase (GLA) gene.

Inflammatory bowel diseases such as ulcerative colitis (UC) may be complicated by several extraintestinal manifestations. These involve joints, skin, eyes and less commonly lungs and heart. Myocarditis may result from the toxic effect of drugs (ie, mesalazine) commonly used for the treatment of UC or due to infections (eg, Coxsackieviruses, enteroviruses, adenovirus). Here, we report a case of a 26-year old man affected by UC and complicated by two episodes of myocarditis. Both episodes occurred during two severe exacerbations of UC. However, in both cases the aetiology of myocarditis remains uncertain being ascribable to extraintestinal manifestation, drug toxicity or both.

Background: The intake of mineral water for therapeutic purposes (crenotherapy) in digestive system disorders is a long-established practice, but there are still few controlled clinical studies confirming the effect of natural mineral water rich in bicarbonate. Objective: To verify whether the daily intake of Aqua 3 bicarbonate natural mineral water is able to improve digestion in a population of patients with functional dyspepsia and gastroesophageal reflux disease symptoms. Methods: Patients with a diagnosis of functional dyspepsia, formulated in accordance with the Rome IV criteria, were subjected to three 2-week intake periods: a tap water period (wash-out), a bicarbonate natural mineral water period, and an oligomineral water period. The mineral water bottles were anonymized by removing the identifying labels. The primary efficacy endpoint was the change in the Patient Assessment of Upper Gastrointestinal Disorders–Symptom Severity Index (PAGI-SYM) total score Secondary endpoints were: improvements in the PAGI-SYM subscale scores, the use of antacids, and the self-assessment of efficacy of digestion. Power analysis indicated that a minimum of 48 pairs was required and, to ensure adequate sample size, 50 subjects were enrolled Results: The PAGI-SYM total score and the six subscale scores significantly decreased after bicarbonate mineral water intake and significantly increased after oligomineral water supplementation. During the bicarbonate mineral water period, antacid use decreased significantly, with 9 patients discontinuing antacid medication (P = 0.004). During the subsequent oligomineral water period, antacid use increased, with 7 patients requiring new antacid administration, although this increase did not reach statistical significance (P = 0.070). The comparison between changes observed during the bicarbonate and oligomineral water periods was significant (P = 0.005). In addition, the score of the patients’ subjective assessment of the effectiveness of their digestion was significantly better after the intake of bicarbonate water than after intake of oligomineral water. Conclusions: In line with the evidence reported in the literature, hese preliminary findings suggest that the intake of Aqua 3 bicarbonate mineral water may alleviate dyspeptic and reflux-related symptoms and improve digestive effectiveness in patients with functional dyspepsia. Given the exploratory design, small sample size and fixed treatment sequence, these results should be interpreted as hypothesis-generating and require confirmation in adequately powered randomized controlled trials. The intake of Aqua 3 bicarbonate mineral water proved to be a simple, safe, and natural intervention capable of improving digestive symptoms in patients with functional dyspepsia and reflux-related disorders while promoting the digestive process.