Intestinal Diseases in Men and Women: Etiology, Diagnosis, and Therapeutic Approaches

Background/Objectives: Intestinal diseases constitute a significant global public health issue and encompass a broad spectrum of inflammatory, functional, and infectious disorders, including inflammatory bowel disease (Crohn’s disease and ulcerative colitis) and irritable bowel syndrome. In recent years, increasing attention has been paid to sex-related differences in epidemiology, clinical course, diagnosis, and treatment outcomes. Methods: A structured narrative review was conducted using the PubMed, Scopus, and Web of Science databases to identify publications addressing sex-related differences in the epidemiology, pathophysiology, diagnosis, and treatment of intestinal diseases. The aim of the study was to examine sex-based differences in the etiology, diagnosis, and treatment of intestinal diseases. Results: The development of intestinal diseases is determined by the interaction of genetic, immunological, hormonal, microbial, and environmental factors. Sex-related differences were identified in disease prevalence, clinical course, and progression and are associated with hormonal regulation, immune response characteristics, and gut microbiota composition. Diagnosis of intestinal diseases is based on a combination of laboratory biomarkers, endoscopic, and imaging techniques, and diagnostic accuracy may vary according to biological sex. Video capsule endoscopy, balloon-assisted enteroscopy, and advanced imaging methods, including computed tomography colonography, improve the evaluation of small bowel diseases, whereas chromoendoscopy, colonoscopy, and cross-sectional imaging play important roles in the assessment of colonic disorders. Treatment includes pharmacological, dietary, microbiota-based, endoscopic, and surgical approaches. Current evidence suggests that biological sex may influence treatment response, adverse event profiles, and clinical outcomes; however, the available evidence remains limited or inconsistent for several therapeutic strategies, highlighting the need for further sex-specific clinical research. Conclusions: Sex-related differences should be considered to improve diagnostic accuracy, optimize treatment strategies, and support individualized clinical management. Although evidence remains limited in several areas, current findings support the integration of biological sex into clinical decision-making. Further research is needed to establish sex-specific diagnostic and therapeutic approaches.