Skip to main content icon/video/no-internet
icon backReturn to Entries

Gastrointestinal Aging

Many age-related changes in gastrointestinal (GI) function are not due to aging alone. The presence of concurrent diseases (e.g., diabetes and atherosclerotic disease) may have more impact on GI tract function in older adults. Given the large functional reserve capacity of the GI tract, older adults can retain normal physiological function during aging. However, aging is associated with an increased prevalence of several GI disorders, so clinically significant abnormalities in GI function, including reduced food intake and constipation, should be evaluated and not attributed to aging.

Oral Cavity and Esophagus

Taste sensation and saliva production decrease with aging. A number of drugs and diseases can also affect taste, and reversible causes of taste impairment must be considered. Drugs can also affect saliva production and may contribute to the severity of acid reflux in the elderly. Although dentition may be well preserved, the presence of dental decay and tooth loss can lead to problems with mastication and reduced caloric intake. Poor dentition (often from ill-fitting dentures) is common, and in some populations more than 60% of the elderly are edentulous (toothless).

In healthy people, aging has only minor effects on esophageal motility. Upper esophageal sphincter pressure gradually decreases with age and is associated with a delay in swallow-induced relaxation. Lower esophageal sphincter pressure does not seem to change unless other disease processes are present. Secondary peristalsis (waves of muscle contraction anywhere in the GI tract that move contents along) is elicited less consistently by esophageal distention, which may impair the clearance of refluxed acid and bile. Presbyesophagus (a condition associated with marked abnormalities in esophageal peristalsis) is attributable to neurological or vascular disorders that affect esophageal function more often than it is to age-related changes.

Gastroesophageal reflux disease (GERD) describes a backflow of acid from the stomach into the swallowing tube or esophagus. It appears to be as prevalent in elderly people as in young people, and although it causes milder symptoms, it tends to be associated with more severe disease, possibly because of impaired acid clearance. Body weight and an increased incidence of hiatus hernia may also be important factors for development of GERD. Esophagitis is the inflammation and ulceration that forms from irritation of the esophagus. The elderly are at higher risk for drug-induced esophagitis and its complications because of high prescription rates. Often, over-the-counter drugs, such as nonsteroidal anti-inflammatory drugs (NSAIDs), may contribute to esophageal injury.

Stomach

Aging has no significant effect on stomach secretion of acid and pepsin. However, conditions that reduce acid production are common. Hypochlorhydria is a reduction in basal and stimulated gastric acid secretion that does occur with aging and can be related to atrophic gastritis. Atrophic gastritis is a histopathologic finding characterized by chronic inflammation of the gastric mucosa with loss of gastric glandular cells and replacement by intestinal-type epithelium and fibrous tissue. Atrophic changes are increased byHelicobacter pylori infection. Appropriate treatment early in life may prevent some of these changes that occur gradually over time.

Evidence indicates that aging diminishes the barrier function of the gastric mucosa to protect against insult. Factors involved with mucosal protection that decrease with aging include gastric mucosal blood flow and secretion of prostaglandin, glutathione, bicarbonate, and mucus production. These changes may account for the increased risk of gastric and duodenal ulcers in the elderly, particularly those caused by NSAIDs andH. pylori. Aging is associated with slowing of gastric emptying that may prolong gastric distention. In older adults, this effect would contribute to early satiety and lead to decreased food intake.

...

  • Loading...
locked icon

Sign in to access this content

Get a 30 day FREE TRIAL

  • Watch videos from a variety of sources bringing classroom topics to life
  • Read modern, diverse business cases
  • Explore hundreds of books and reference titles

Read next

More like this

Sage Recommends

We found other relevant content for you on other Sage platforms.

close

Have you created a personal profile? Login or create a profile so that you can save clips, playlists and searches

close
close
close Signed In to profile You are signed in as:
close
Logged in Institution Institution