Elana S. Lavine, BSc
Irritable bowel syndrome (IBS) is a very common gastrointestinal disorder typically characterized by abdominal pain, bloating, and constipation and/or diarrhea. There is no known organic disease process in the gastrointestinal tract, and no pathology is observed when the colons of patients with IBS are examined via endoscopy. IBS can, therefore, be categorized as a functional illness. However, certain differences have been observed experimentally between the colons of IBS patients and normal controls (see pathophysiology). The onset of novel IBS-like symptoms in the elderly patient merits a thorough investigation. Successful management may require both symptomatic treatment and emotional support from a physician.
Epidemiology
IBS is considered a syndrome of the young and middle-aged; in the elderly, it may be a reluctant diagnosis.1 Fifty percent of patients experience an onset of symptoms before age 35, and another 40% between the ages of 35 to 50.2 One recent study followed a cohort of 2,956 newly-diagnosed IBS patients, ranging in age from 20-79, and noted that only 12% were above 60 years of age.3 One national study conducted in the UK indicated that prevalence rates dropped between 78% and 92% from middle to old age.4 The question has been raised as to whether such statistics reflect a true decline in incidence with age, or an underreporting.
