The prevalence of irritable bowel syndrome (IBS) is almost universal. Although often thought to be a disorder of young females, IBS is diagnosed in both genders and all age groups. IBS manifestations in the older adult should trigger further differential diagnoses and more extensive diagnostic studies than would be in a younger adult. What would be termed as IBS in a younger individual may be diagnosed as diverticulosis in the old. Because of what is perceived as a general reluctance to make a diagnosis of IBS in this age group, the true prevalence of IBS in the elderly is not known. The pathogenesis of IBS is not clear; there is an interesting suggestion that altered gut microbiota may be involved. IBS may be constipation or diarrhea predominant. Because of the fact that the elderly are likely to have comorbid processes, the symptomatology should not be dismissed without appropriate evaluation, nor should therapy be initiated without consideration for adverse drug events.
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