Gender-related differences in irritable bowel syndrome: Potential mechanisms of sex hormones

Figure 1 Possible mechanisms of action of ovarian hormones in the pathophysiology of irritable bowel syndrome. Arrows show increase or decrease. The symbol “+” after the name of a protein indicates upregulation of the protein. The symbol “-” indicates downregulation of the protein. E2: Estradiol; JAM: Junctional adhesion molecule; NK: Neurokinin; PG: Prostaglandin; P4: Progesterone; VGCC: Voltage-gated calcium channel; IBS: Irritable bowel syndrome; GI: Gastrointestinal.

Figure 2 Integrative multiple hits model of irritable bowel syndrome pathophysiology. CNS: Central nervous system; ENS: Enteric nervous system; 5-HT: 5-hydroxytryptamine; ER: Estrogen receptor. Adapted from Mayer et al[139].