Irritable Bowel Syndrome

Though traditionally viewed as a disorder of young adult females, it is now evident that irritable bowel syndrome (IBS) does occur in the elderly. Whether physiological aging contributes to the emergence of IBS-type symptoms has yet to be defined, and areas such as the gut microbiome are of considerable interest in this regard. On a much more practical level the major challenge that confronts the clinician in making the diagnosis of IBS in the elderly is the differential diagnosis. Given the high prevalence of disorders such as colon cancer, diverticulitis, microscopic colitis, and depression in the elderly, the clinical assessment of the older individual with IBS-type symptoms is certainly more daunting, and there is a great need for the validation of a positive criteria-based diagnosis of IBS in this population. There is little data on management strategies for IBS in the elderly; at the very least, the prescriber needs to be alert to possible side effects and drug interactions.