The Aging Gi Tract - How The Gut Works: Digestive Disorders

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The aging GI tract

Aging takes a toll on the GI tract. Aging muscles, including the digestive muscles, contract more slowly, take plenty of time relaxing, and move their contents along at a more leisurely pace. For the most part, that's fine — unless you become impatient, take drastic measures to hurry things along, or develop a condition that needs a doctor's attention. Many of the aging GI system's failures can be prevented or corrected.

The mouth. The changes begin at the top, in the mouth, where the number of taste buds begins to decline with age. So does the sensitivity of those that remain. The chewing muscles also begin to weaken. As a result, some older folks lose interest in food, begin to lose weight, and develop nutritional deficiencies. Losing teeth may also reduce interest in eating. Good dental care is important to keep the teeth in shape so that eating doesn't become a problem.

The esophagus. Swallowing can also become more difficult as people age. Such problems are usually the result of neurological or muscular disorders. The very old may experience a weakening of the muscles of the esophagus, which contract less vigorously around food after swallowing. Acid reflux is often a problem in the elderly, the result of the decline in esophageal contractions and in the function of the lower esophageal sphincter muscle. However, since the esophagus may be less sensitive to acid with age, acid reflux may not result in heartburn. Instead, patients may complain of nausea or vague chest discomfort. Any new onset of difficulty in swallowing should be evaluated by a doctor because the problem could be related to cancer of the esophagus or to a motor disorder (achalasia), more common in those who are older.

The stomach and duodenum. As people age, the stomach continues to make acid, but in many older people, acid production declines because of years of carrying Helicobacter pylori infection in the stomach, leading to long-term gastritis and to atrophy of the stomach lining. While a reduction in gastric acid does not usually interfere with digestion, it can lead to two disorders that are common in the elderly — vitamin B₁₂ deficiency, which can result in anemia and nerve damage, and excessive bacterial growth in the small intestine, resulting in malabsorption and poor digestion. Both problems can be corrected.

The colon. Moving one's bowels may be the most frequent gastrointestinal challenge associated with aging. The problem is usually the result of a poorly functioning or diseased large intestine. Problems with this organ can also result in diarrhea and hemorrhoids. In addition, the risk for colon cancer and polyps increases with age. In fact, one in three senior citizens has one or more polyps in the colon. That's why a screening exam called a colonoscopy is recommended on a regular basis after age 50. Since colon cancer evolves from polyps, removal of polyps will keep colon cancer from getting started. In general, less stool is passed after one reaches age 65. In part, this may be the result of a change in diet to softer foods, a decreased appetite, or diminished muscular activity of the colon. Constipation may also be the result of a neurological problem (see "Constipation").

Last updated:	August 21, 2007