The prevalence of chronic gastrointestinal symptoms and the irritable bowel syndrome (IBS) in the elderly, and their impact on health, is largely unknown. The prevalence of symptoms compatible with IBS was estimated in a representative sample of elderly community residents, and the impact of these symptoms was determined on presentation for health care. An age- and sex-stratified random sample of noninstitutionalized Olmsted County, Minnesota, residents aged 65-93 years were mailed a valid questionnaire; 77% responded (n = 328). The age- and sex-adjusted prevalence (per 100 persons) of frequent abdominal pain was 24.3 [95% confidence interval (CI), 19.3-29.2]. Chronic constipation and chronic diarrhea had prevalences of 24.1 (95% CI, 19.1-29.0) and 14.2 (95% CI, 10.1-18.2), respectively. Fecal incontinence more than once a week was reported in 3.7 per 100 (95% CI, 1.6-5.9). The prevalence of symptoms compatible with IBS (greater than or equal to 3 Manning criteria with frequent abdominal pain) was 10.9 per 100 (95% CI, 7.2-14.6). Among the subjects sampled who had abdominal pain, chronic constipation, and/or chronic diarrhea (n = 152), only 23% had seen a physician for pain or disturbed defecation in the prior year, and this behavior was poorly explained by the symptoms. It is concluded that complaints consistent with functional gastrointestinal disorders are common in the elderly, but symptoms are a poor predictor of presentation for medical care.