As we age, our body goes through many changes, but do these changes affect your IBS? Have you noticed symptoms worsen or have they improved? Kirsten Jackson, Consultant IBS Dietitian, explains how age affects IBS and what you should do about it.

How does our IBS change as we age?

IBS can develop at all ages. However, the onset of symptoms after the age of 65 is rare. The likelihood of developing IBS increases during adolescence and young adulthood.

Ageing is linked to an increased risk of developing a range of health conditions. The management of IBS can become more complex in the elderly compared to the younger populations.

Potentially, in adult life, more stressors can exacerbate gut symptoms. For example, work stress, poor mental health, and busy lifestyles. It is important to find ways to manage stress to reduce the onset of stress-related IBS symptoms.

How we manage IBS as we age fundamentally stays the same. Below are the main areas you need to consider:

1. Identifying dietary triggers

It is important to pinpoint trigger foods to create a diet that gives you food freedom; following a low FODMAP diet is best for this.

The Low FODMAP Diet is a three-stage tool developed by Monash University to help those with IBS to identify which foods and in what quantities they can eat. After 12 weeks, and having discovered what foods to eat and what to avoid, people then follow a tailor-made diet containing predominately-low FODMAP foods that are right for them. The 12 week Low FODMAP Diet must be done under the supervision of a registered dietitian as it can be demanding and is complex.

2.  Sleep

Getting enough sleep is essential for good gut health. People should average between seven and nine hours per night. Tips to consider:

  • Try setting a bedtime routine.
  • Go to bed and get up at the same time every day.
  • Avoid naps throughout the day.
  • Take time to relax before you go to bed.
  • Avoid eating, talking on the phone, using computers, smartphones or watching television in bed.
  • Make sure your room is reasonably tidy and well ventilated

3. Exercise

Try to incorporate at least 30 minutes of daily activity to help keep the gut moving and to reduce constipation. But take care, high-intensity workouts may also trigger IBS. Also, during exercise, endorphins, the feel-good hormones, are released, which will help boost your mood and leave you in a more positive frame of mind.

4. Fluid

Consistent fluid intake is important to keep the gut moving and to avoid constipation. (Make sure you avoid caffeine and fizzy drinks though).

5. Eating adequate amounts of fibre

We know that fibre is essential to get the gut moving and we should aim for 30g per day.

If you have IBS-C, you may be able to tolerate more fibre and it will help to relieve constipation. If you have IBS-D, you might find it harder to tolerate higher amounts of fibre and it could cause loose stools. Therefore, it is important to find your tolerance.

Make sure you increase this gradually to avoid symptoms such as bloating, pain, and gas. Also, increase your water intake, otherwise, you may become constipated.

Some simple steps to add fibre into your meals are:

  • Add nuts and seeds to your breakfast or snack on them throughout the day.
  • Add beans and pulses to your meals (if you can tolerate them).
  • Add low FODMAP fruits and vegetables to your meals, e.g. kiwis, strawberries, carrots, cucumbers, and courgettes.
  • Leave the skins on your fruits and vegetables

6. Stress management

Stress is a common IBS trigger because of the close gut-brain axis connection. It is important to recognise stress, identity from where it is coming, and do your best to self-manage.

Stress management means tools and techniques which you can use every day or when you are stressed or are going through a stressful period. Examples include walking, reading a book, watching a film, meditation, yoga, having a bath or a massage — anything that will relax you and keep you ‘in the moment’.

Remember that everyone’s stress management techniques will differ, so it is important to find what works for you.

Age and gut microbiome

Age can have a negative impact on the gut microbiome, and therefore, your overall gut health. As we get older, our lifestyle often changes. For example, our diet, increased use of medically prescribed drugs, less physical activity and our social environment will affect the gut microbiome.

Keeping up with the multifactorial approach mentioned above is key to maintaining good gut health throughout life.

Can menopause worsen IBS?

We have very little research and do not know if menopause worsens IBS or not. Menopause causes many unpleasant symptoms as your body goes through a period of hormonal changes. One of these symptoms is the worsening of your digestion.

Research suggests that digestive symptoms do seem to worsen during the ages of 40-49. We also know that 38% of women report digestive problems post-menopause. There is only one study looking at how menopause affects IBS specifically. However, the study showed that there was no difference between men and women at different ages.

As well as digestive symptoms, you may notice other changes in your body such as difficulty sleeping, low mood, and anxiety. We know that these changes are directly related to worsening IBS.

In summary

Overall, we do not have sufficient research to suggest that ageing worsens the symptoms of IBS.

Throughout all ages, we must implement the multifactorial factors of IBS management that we know work and have a positive impact.

It is important to focus on your sleep, fluid, fibre, exercise, and stress management. This will make a significant difference to your overall IBS symptoms.

REMEMBER: If you need support with your IBS, ask your GP for a referral to an IBS specialist registered dietitian.

Kirsten Jackson is a consultant gastroenterology dietitian and founder of The Food Treatment Clinic.