As we age, our bodies undergo many changes that can affect various bodily systems, including the digestive (or gastrointestinal) system, a collection of vital organs that break down food into components for the body to use. In addition to the physiological changes, GI issues can impact one’s quality of life and overall health.
Research has shown that ageing contributes to some changes in gut function that have implications for oesophageal, gastric, and colonic motility. This results from weakened nerves and muscles that do not work well together or without sufficient force.
In this article, gastroenterologist Dr. Loh Poh Yen sheds light on common GI issues that older adults encounter and their implications.
Age-related physiological changes can lead to a decline in immunologic, neurologic, and metabolic systems, indirectly affecting GI function.
Other factors that play a more significant role in altering GI function in older adults are:
Prevalence: 15% in community-dwelling elderly, 5% to 85% in institutionalised elderly.
Causes: Reduced food intake due to social isolation, physical handicaps, dental issues, changes in taste and smell, anorexia, or cognitive dysfunction.
Complications: Patients are at a higher risk of falling and bone fracture, as well as more prone to infections.
Impact: Loss of body fat and lean body mass, contributing to overall frailty.
Tips/Treatment(s): You can include more protein in your diet and exercise to build the muscle mass. Do also follow your dietitians advice on what to include in your meals.
Prevalence: 35% to 68% of elderly individuals experience some degree of dysphagia.
Causes: Any condition that weakens or damages the muscles and nerves used to swallow or causes narrowing of the back of the throat or oesophagus.
Complications: Aspiration pneumonia, malnutrition, and dehydration.
Types:
Impact: Reducing your oral intake of food can result in malnutrition and its related complications such as hypoglycaemia, dehydration, and electrolyte imbalances.
Tips/Treatment(s): You should approach a speech therapist for advice on techniques for swallowing and diet modification. Some patients with swallowing difficulties may need gastroscopy evaluation to rule out esophageal obstruction.
Prevalence: It is a common, but rarely reported, condition.
Causes: Certain medications such NSAIDS, bisphosphonate can cause the condition. It is more common if you are taking many medications (polypharmacy).
Complications: Pill esophagitis can cause chest pain due to esophageal ulcer.
Impact: It may result in reduced food intake due to the pain of swallowing.
Symptoms: You may feel like a pill is stuck in your throat and experience chest pains, difficulty swallowing and pain when swallowing.
Tips/Treatment(s): Ensuring medications are taken with sufficient water and avoiding lying down for at least 30 minutes post-administration.
Prevalence: Bloating is reported by 6% to 31% of the general population .
Causes: Small bowel function generally remains stable due to the significant functional reserve of the small intestine – which means that movement of contents through the small intestine and absorption of most nutrients does not change much, and enzyme secretion and absorptive function are not significantly different.
Complications: Some bloating conditions can lead to malnutrition and the reduced absorption of nutrients.
Impact: Patients suffering from indigestion and bloating may experience anemia and weight loss.
Tips/Treatment(s): Dr. Loh recommends patients to reduce their intake of food which produce gas such as the FODMAP diet. If you notice symptoms which may be causes for alarm such as weight loss and diarrhoea, do consult a gastroenterologist for a proper evaluation.
Prevalence: 35% of elderly patients.
Causes: In the large intestine and rectum, constipation becomes more common due to factors such as slower movement of contents, decreased rectal contractions, medication side effects, less physical activity, and pelvic floor weakness in older women. Other contributing factors include reduced mobility, cognitive impairment, medical comorbidities (e.g., diabetes, hypothyroidism), polypharmacy, and dietary changes.
Complications: Constipation may be caused by abnormal growth in the colon, resulting in an intestinal obstruction.
Impact: Patients with constipation may experience abdominal pain, bloating. In rare instances, it may cause stool impaction where you will need a digital evacuation of the impacted faeces.
Medical Tests: Colonic transit study, anorectal manometry, and colonoscopy.
Tips/Treatment(s): Staying active, increasing dietary fibre and water intake, and using stool softeners or laxatives as needed.
GI issues in older adults are usually a result of multiple factors brought on by ageing, which necessitate a holistic treatment approach. Gastroenterologists may employ one or more of the following modes of action or evaluation:
Dr. Loh Poh Yen stresses the importance of a thorough and holistic approach to managing ageing-induced GI-related conditions. By understanding the physiological changes, joint conditions, and effective management strategies, older adults can take proactive steps to strengthen their digestive health and maintain or improve their quality of life.
Please seek professional help from a gastroenterologist if you are experiencing persistent GI symptoms. Speak to our specialists today.
