Irritable Bowel Syndrome (IBS) can affect individuals over 50 in various ways, and its
presentation may differ from younger adults, but actually the symptoms may be exactly the
same, throughout life, independent of age. While many cases of IBS begin in childhood or at a
younger age, IBS may begin at any age , even in ones 80-90’s. All of the symptoms noted below
are possible , in any combination , or singly. Here are some common characteristics and
considerations for IBS in this age group:
Symptoms:
1. Abdominal Pain: This is often cramping and can be relieved by bowel movements. Often
begins before a BM, and often follows a meal.
2. Bloating and Gas: Increased bloating and gas can be particularly bothersome, and
usually occur within 30-60 minutes after meals. .
3. Changes in Bowel Habits: Some may experience diarrhea (IBS-D), constipation (IBS-
C), or alternating patterns (IBS-A).
4. Urgency: There can be a sudden, strong urge to have a bowel movement, which may be
distressing.This is known as fecal urgency, and mostly occurs within an hour of a meal,
but not necessarily every meal.
Age-Related Considerations:
1. Coexisting Conditions: Older adults may have other health issues (like stress or anxiety
in particular) that can complicate IBS management.
2. Medication Interactions: Medications for other conditions might affect bowel function
or interact with IBS treatments. Specifically narcotics or any sort of medications like
Imodium, loperamide, Lomotil, that can slow down the peristalsis of the bowel. Other
medical conditions like Parkinson’s disease, lupus and any neurological illness that leads
to immobility, including paraplegia, can cause exacerbation of constipation.
3. Dietary Needs: Poor eating habits and decreased intake of fiber and fluid on a regular
daily basis exacerbate IBS –C, but there are really no dietary measures that resolve all
IBS symptoms. A prudent diet, with 20-40 gm fiber /day . 48-64 oz fluids /day, and
avoidance of fried and fatty foods in abundance may all be helpful to ameliorate the IBS
symptoms.
4. Decreased Mobility: Limited mobility can affect physical activity levels, which may
exacerbate IBS symptoms.
Diagnosis and Management:
1. Comprehensive Evaluation: It’s essential to rule out other gastrointestinal disorders, as
symptoms can overlap with conditions like colon cancer, although IBS is very common
and colon cancer is not in comparison. IBS will never causes rectal bleeding, but colon
cancer often will. Infernal hemorrhoids however, are benign, common and cause
bleeding, and may occur in anyone.
2. Dietary Modifications: Dietary adjustments can help manage symptoms as noted above..
3. Stress Management: Stress can exacerbate IBS symptoms, so techniques like
mindfulness or therapy may be beneficial.
4. Medical Treatments: There are a number of old medications and some new ones that
can treat many of the symptoms of IBS. One cannot cure it, without first resolving all the
etiologies of internalized stress and most people with IBS have internalized stress that
they recognize, or often they do not. When it is improved with either conservative
measures or medications, the IBS symptoms improve as well.
While IBS is common among older adults, it’s crucial to approach symptoms thoughtfully,
especially given the potential for other underlying health concerns. If someone experiences
significant changes in their gastrointestinal health, they should consult a healthcare professional
for proper thoughtful evaluation and management.
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