Does IBS Get Worse with Age?

Although IBS can affect people of any age, some weeks it does seem as though I see more middle-aged and older patients in my practice than I might expect. What are the diet-related factors that might cause more gas, bloating, abdominal pain, diarrhea or constipation in older folks?

• Lactose intolerance is rare in young children, but common in older teens and adults. 
• Some patients are trying to be responsible adults and eat more healthfully. This might result in increased intake of FODMAP carbohydrates and result in symptoms. (Luckily you can use the IBSFree diet in my book to figure out which healthy foods you can tolerate well).
• Older adults are more likely to have diabetes, or have friends or family members with diabetes; sugar-free candies are popular with this crowd, and they often contain large amounts of sugar alcohols. Sugar alcohols such as sorbitol and maltitol are well known laxatives. Metformin, an oral diabetes medication, decreases sugar absorption, which can worsen IBS symptoms for some people.
• Conditions such as diverticulitis and c. difficile infection are more common in older individuals. The strong antibiotics that are prescribed for these conditions sometimes leave functional GI symptoms in their wake.

IBS related to most of the above age-related factors may respond well to changes in diet, including FODMAP elimination and, later, using probiotics to maintain gut health.

Comments

[Dawn Fildes]

You bet. It also gets worse if you have your gall bladder removed. Despite having a gluten free diet and limited dairy....

[Nancy D. Hall]

I have been doing a low carb wheat free diet for several years for diabetes. Then, ibs caused me to try the S.C. D diet, specific carbohydrate diet.

I still have problems. But I have been relying on almond flour bread. What is it about nuts that we should avoid on FODMAPS?

Nancy

[Patsy Catsos]

Nuts contain fructans and galactans,neither of which is normally digestable, so they WILL act as FODMAPs. People who are sensitive to this should limit nuts to one handful or the equivalent in flour at a time. Pistachios also contain sugar alcohols, so they tend to be the worst. I think you would find my book very interesting. Though SCD and low FODMAPs have some things in common there are a number of subtle differences that you might find explain your remaining problems.

[Nancy D. Hall]

Yes, I have your book. I cannot find out whether peaches are allowed. We are in the middle of a visit in Florida. Local peaches are expected today in the market. It would be wonderful to hear from you promptly.

Thank you. Nancy

[Patsy Catsos]

You can't see your questions until I have a chance to review and publish them. I tried going without this step in the past, but got so many spam posts it was impossible. Peaches are high in FODMAPs and are not allowed on the elimination phase of the diet. You will find them on the the Fructose/Polyol challenge, pg. 63. Enjoy your time in FL.

[Rebecca]

Hi Patsy!

I was actually wondering about the fact that IBS seems so prevalent in the adult population and yet rarely affects children before their teenage years. Do you have any idea why IBS not only seems to worsen with age but also seems virtually absent from the paediatric population? (with the exception of post-antibiotic IBS which is rather different). I had no GI problems whatsoever until I was about 20, I could eat anything at all, now it's quite a different story! If you have any ideas from an expert viewpoint I'd appreciate them, purely out of curiosity :-)

[Patsy Catsos]

Well, I have thought about this, and you commented on the post that summarizes my thoughts pretty well as to why IBS might occur at an older age for certain people. I don't have too much more to add, except to say I don't agree that IBS is absent in the pediatric population. Most studies have concluded the prevalence of IBS is very similar in adults and children.