Age-related reductions in visceral sensitivity and slower colonic transit may be associated with variations in symptom presentation, suggesting age should be considered in IBS management strategies.

Variations in irritable bowel syndrome (IBS) symptoms and gut physiology were reviewed across a cohort of 1,677 patients (74% female; mean age, 39 years). Patients were stratified by age (18-29, 30-49, and 50 or older years) to assess gastrointestinal and non-GI symptom severity, quality of life (QoL), and specific gut physiology metrics, including transit time and anorectal sensitivity.

Results, published in npj Gut and Liver, indicated that younger patients report more severe GI symptoms, such as abdominal pain, bloating symptoms, and diarrhea, compared to older patients. Slower gut transit time was observed with advancing age and was associated with increased constipation severity. Additionally, older patients exhibited altered anorectal function, specifically lower rectal sensitivity, which may reduce perception of abdominal discomfort. QoL domains related to physical and social functioning appear to improve with age, although sleep-related QoL was found to decline.

Statistical models indicated that younger age, slower transit, and psychological distress were independently associated with increased GI symptom severity. For example, constipation severity correlates with slower transit time, while rapid transit may be independently associated with more severe diarrhea. Psychological factors, including anxiety, exacerbated abdominal bloating and overall GI symptoms, particularly in younger patients.

Researchers suggest that future IBS studies incorporate age as a variable to better understand its impact on symptomatology and gut physiology.

Study limitations include combining IBS patients diagnosed under different criteria, where Rome IV generally indicates a more severe form of IBS; however, symptom severity appeared consistent across Rome II, III, and IV diagnoses. Additionally, the cross-sectional design limited causal interpretations, age stratification may have led to data loss, and not all participants completed every physiological measure.

Full disclosures can be found in the published study.