Figure 4.

Sex hormone and brain–gut axis in irritable bowel syndrome (IBS). E, estradiol; T, testosterone; P, progesterone; HPA, hypothalamic-pituitary-adrenal; CRH, corticotropin-releasing hormone; ACTH, adrenocorticotropic hormone; CNS, central nervous system; RhoA, Ras homolog family member A; GTP, guanosine-5’-triphosphate; CCK, cholecystokinin; PGE2, prostaglandin E2; IBS-D, IBS with diarrhea; 5-HT, 5-hydroxytryptamine; ER, estrogen receptor; DRG, dorsal root ganglion; JAM-A, junctional adhesion molecule-A. Adapted from Kim and Kim.⁸⁴