Skip to main content Accessibility help
×
Hostname: page-component-77c78cf97d-lphnv Total loading time: 0 Render date: 2026-05-02T23:46:52.868Z Has data issue: false hasContentIssue false

Chapter 23 - Gastrointestinal Disorders

from Section III - Care of the Elderly by Organ System

Published online by Cambridge University Press:  30 June 2022

By
Ekta Gupta  and
Anthony N. Kalloo
Edited by
Jan Busby-Whitehead ,
Samuel C. Durso ,
Christine Arenson ,
Rebecca Elon ,
Mary H. Palmer  and
William Reichel
Jan Busby-Whitehead
Affiliation:
University of North Carolina, Chapel Hill
Samuel C. Durso
Affiliation:
The Johns Hopkins University, Maryland
Christine Arenson
Affiliation:
Thomas Jefferson University, Philadelphia
Rebecca Elon
Affiliation:
The Johns Hopkins University School of Medicine
Mary H. Palmer
Affiliation:
University of North Carolina, Chapel Hill
William Reichel
Affiliation:
Georgetown University Medical Center
Get access

Summary

Aging leads to progressive deterioration of physiological function and predisposes to pathological processes. Common geriatric syndromes (such as depression, dementia, falls, mobility impairment, delirium, and osteoporosis), along with age-related impairment in appetite, absorption, and food intake, affect nutrition, symptom presentation, and response to therapy of common gastrointestinal (GI) disorders in the elderly. Age-associated changes in drug metabolism and polypharmacy can result in potential interactions and side effects of drugs used in the treatment of GI diseases, which in turn complicates their management. Polypharmacy, which is common in the elderly, can also exacerbate digestive symptoms. Elderly patients with neurocognitive decline often have atypical presentation of their GI disorders. These factors can make the diagnosis of GI diseases in the elderly more challenging, as they may require different management approaches. In this chapter, we discuss the common GI disorders that affect the elderly with special focus on age-related pathophysiology and clinical implications.

Keywords

gastrointestinal disorderselderlyagedgeriatricagingGI diseases

Information

Type
Chapter
Information
Reichel's Care of the Elderly
Clinical Aspects of Aging
 , pp. 286 - 296
Publisher: Cambridge University Press
Print publication year: 2022

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

Book purchase

Temporarily unavailable

References

Moore, KL, Boscardin, WJ, Steinman, MA, Schwartz, JB. Age and sex variation in prevalence of chronic medical conditions in older residents of U.S. nursing homes. J Am Geriatr Soc. 2012; 60(4):756–764.Google Scholar
Dumic, I, Nordin, T, Jecmenica, M, Stojkovic Lalosevic, M, Milosavljevic, T, Milovanovic, T. Gastrointestinal tract disorders in older age. Can J Gastroenterol Hepatol. 2019 (Jan. 17); 2019:6757524.Google Scholar
Gupta, E, Bansal, D, Sotos, J, Olden, K. Risk of adverse clinical outcomes with concomitant use of clopidogrel and proton pump inhibitors following percutaneous coronary intervention. Dig Dis Sci. 2010; 55(7):1964–1968.Google Scholar
Fei, L, Rossetti, G, Moccia, F, et al. Is the advanced age a contraindication to GERD laparoscopic surgery? Results of a long term follow-up. BMC Surg. 2013; 13(Suppl. 2):S13.Google Scholar
Gatenby, P, Bhattacharjee, S, Wall, C, Caygill, C, Watson, A. Risk stratification for malignant progression in Barrett’s esophagus: Gender, age, duration and year of surveillance. World J Gastroenterol. 2016; 22(48):10592–10600.CrossRefGoogle ScholarPubMed
Yousef, F, Cardwell, C, Cantwell, MM, Galway, K, Johnston, BT, Murray, L. The incidence of esophageal cancer and high-grade dysplasia in Barrett’s esophagus: A systematic review and meta-analysis. Am J Epidemiol. 2008; 168(3):237–249.Google Scholar
Ko, MS, Fung, KZ, Shi, Y, Espaldon, R, Shergill, A, Walter, LC. Barrett’s esophagus commonly diagnosed in elderly men with limited life expectancy. J Am Geriatr Soc. 2016; 64(10):e109–e111.CrossRefGoogle ScholarPubMed
Durazzo, M, Campion, D, Fagoonee, S, Pellicano, R. Gastrointestinal tract disorders in the elderly. Minerva Med. 2017; 108(6):575–591.Google Scholar
Cabre, M, Serra-Prat, M, Palomera, E, Almirall, J, Pallares, R, Clavé, P. Prevalence and prognostic implications of dysphagia in elderly patients with pneumonia. Age Ageing. 2010; 39(1):39–45.Google Scholar
Lasch, H, Castell, DO, Castell, JA. Evidence for diminished visceral pain with aging: Studies using graded intraesophageal balloon distension. Am J Physiol. 1997; 272(1 Pt 1):G1–G3.Google Scholar
Newton, JL. Effect of age-related changes in gastric physiology on tolerability of medications for older people. Drugs Aging. 2005; 22(8):655–661.Google Scholar
Pilotto, A, Franceschi, M, Maggi, S, Addante, F, Sancarlo, D. Optimal management of peptic ulcer disease in the elderly. Drugs Aging. 2010; 27(7):545–558.Google Scholar
Pilotto, A, Franceschi, M. Helicobacter pylori infection in older people. World J Gastroenterol. 2014; 20(21):6364–6373.Google Scholar
Yang, P, Zhou, Y, Chen, B, et al. Overweight, obesity and gastric cancer risk: Results from a meta-analysis of cohort studies. Eur J Cancer. 2009; 45(16):2867–2873.Google Scholar
Fasano, A, Catassi, C. Clinical practice: Celiac disease. N Engl J Med. 2012; 367(25):2419–2426.Google Scholar
Murray, JA, Van Dyke, C, Plevak, MF, Dierkhising, RA, Zinsmeister, AR, Melton, LJ 3rd. Trends in the identification and clinical features of celiac disease in a North American community, 1950–2001. Clin Gastroenterol Hepatol. 2003; 1(1):19–27.Google Scholar
Lohi, S, Mustalahti, K, Kaukinen, K, et al. Increasing prevalence of coeliac disease over time. Aliment Pharmacol Ther. 2007; 26(9):1217–1225.CrossRefGoogle ScholarPubMed
Johnson, MW, Ellis, HJ, Asante, MA, Ciclitira, PJ. Celiac disease in the elderly. Nat Clin Pract Gastroenterol Hepatol. 2008; 5(12):697–706.Google Scholar
Thomson, AB. Small intestinal disorders in the elderly. Best Pract Res Clin Gastroenterol. 2009; 23(6):861–874.Google Scholar
Freeman, HJ. Adult celiac disease in the elderly. World J Gastroenterol. 2008; 14(45):6911–6914.CrossRefGoogle ScholarPubMed
Freeman, HJ. Clinical spectrum of biopsy-defined celiac disease in the elderly. Can J Gastroenterol. 1995; 9(1):42–46.Google Scholar
Rubio-Tapia, A, Murray, JA. Liver involvement in celiac disease. Minerva Med. 2008; 99(6):595–604.Google Scholar
Kärkkäinen, JM, Lehtimäki, TT, Manninen, H, Paajanen, H. Acute mesenteric ischemia is a more common cause than expected of acute abdomen in the elderly. J Gastrointest Surg. 2015; 19(8):1407–1414.Google Scholar
Dukowicz, AC, Lacy, BE, Levine, GM. Small intestinal bacterial overgrowth: A comprehensive review. Gastroenterol Hepatol (N Y). 2007; 3(2):112–122.Google Scholar
Parlesak, A, Klein, B, Schecher, K, Bode, JC, Bode, C. Prevalence of small bowel bacterial overgrowth and its association with nutrition intake in nonhospitalized older adults. J Am Geriatr Soc. 2003; 51(6):768–773.Google Scholar
Talley, NJ, Fleming, KC, Evans, JM, et al. Constipation in an elderly community: A study of prevalence and potential risk factors. Am J Gastroenterol. 1996; 91(1):19–25.Google Scholar
Comparato, G, Pilotto, A, Franzè, A, Franceschi, M, Di Mario, F. Diverticular disease in the elderly. Dig Dis. 2007; 25(2):151–159.Google Scholar
Kelly, CP, LaMont, JT. Clostridium difficile: More difficult than ever. N Engl J Med. 2008; 359(18):1932–1940.Google Scholar
Li, YT, Cai, HF, Wang, ZH, Xu, J, Fang, JY. Systematic review with meta-analysis: Long-term outcomes of faecal microbiota transplantation for Clostridium difficile infection. Aliment Pharmacol Ther. 2016; 43(4):445–457.Google Scholar
Talley, NJ, O’Keefe, EA, Zinsmeister, AR, Melton, LJ 3rd. Prevalence of gastrointestinal symptoms in the elderly: A population-based study. Gastroenterology. 1992; 102(3):895–901.Google Scholar
Mundi, MS, Patel, J, McClave, SA, Hurt, RT. Current perspective for tube feeding in the elderly: From identifying malnutrition to providing of enteral nutrition. Clin Interv Aging. 2018; 13:1353–1364.Google Scholar

Accessibility standard: Unknown

Why this information is here

This section outlines the accessibility features of this content - including support for screen readers, full keyboard navigation and high-contrast display options. This may not be relevant for you.

Accessibility Information

Accessibility compliance for the HTML of this chapter is currently unknown and may be updated in the future.

Save book to Kindle

To save this book to your Kindle, first ensure no-reply@cambridge.org is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about saving to your Kindle.

Note you can select to save to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be saved to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

Find out more about the Kindle Personal Document Service.

Available formats
×

Save book to Dropbox

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Dropbox.

Available formats
×

Save book to Google Drive

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Google Drive.

Available formats
×