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age-associated changes in the digestive system

The digestive system undergoes change with aging. Most GI signs & symptoms are due to pathology. [6] Medications can cause GI disorders in the elderly. [6] Physiology: 1) increased incidence of colonic diverticuli 2) altered mastication & swallowing - diminished saliva production [6] 3) decreased splanchnic blood flow 4) diminished upper & lower esophageal sphincter resting pressure 5) diminished intra-abdominal lower esophageal sphincter length [5] 6) increased esophageal dysmotility, increasingly ineffective peristalsis [5] 7) decreased liver size, cell mass & blood flow 8) impaired clearance of drugs that require extensive phase 1 metabolism 9) decreased inducibility in mixed-function oxidase 10) mild decrease in bilirubin 11) hepatocytes accumulate lysosomes, residual bodies, lipofuscin 12) loss of gastric parietal cells a) decreased acid production b) decreased vitamin B12 absorption 13) impaired response to gastric mucosal injury 14) impaired sense of gastroesophageal reflux [5] 15) diminished pancreatic mass & secretory reserves - increased lipofuscin & fat deposition in pancreas [6] 16) decrease in colonic peristalsis - increased incidence constipation 17) altered intestinal absorption a) diminished Ca+2 absorption b) diminished iron absorption [6] 18) decrease in gut-associated lymphoid tissue (GALT) - movement of T-cells into & out of Peyer's patches may be compromised [7] 19) increase in mucosal cell atrophy [6] 20) enteric neurons may exhibit a senescent phenotype [7] 21) changes in intestinal flora with age correlate with diet & health status [7]

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digestive system digestive system disease

General

age-related physiological changes

References

  1. Essentials of Clinical Geriatrics, 4th ed, Kane RL et al (eds) McGraw Hill, NY, 1999
  2. UCLA Intensive Course in Geriatric Medicine & Board Review, Marina Del Ray, CA, Sept 29-Oct 2, 2004
  3. The Merck Manual of Geriatrics, 3rdh ed, Merck & Co, Rahway NJ, 2000
  4. Taffet GE, Physiology of Aging, In: Geriatric Medicine: An Evidence-Based Approach, 4th ed, Cassel CK et al (eds), Springer-Verlag, New York, 2003
  5. Lee J et al, Effects of age on the gastroesophageal junction, esophageal motility, and reflux disease. Clin Gastroenterol Hepatol 2007, 5:1132 PMID: 17936081
  6. Geriatric Review Syllabus, 8th edition (GRS8) Durso SC and Sullivan GN (eds) American Geriatrics Society, 2013 - Geriatric Review Syllabus, 11th edition (GRS11) Harper GM, Lyons WL, Potter JF (eds) American Geriatrics Society, 2022
  7. Saffrey MJ Aging of the mammalian gastrointestinal tract: a complex organ system. AGE. Dec 20, 2013 http://link.springer.com/article/10.1007/s11357-013-9603-2/fulltext.html?wt_mc=alerts.TOCjournals
  8. Xu F, Laguna L, Sarkar A. Aging related changes in quantity and quality of saliva: where do we stand in our understanding? J Texture Stud. 2019;50:27-35 PMID: 30091142 Free article https://onlinelibrary.wiley.com/doi/10.1111/jtxs.12356