problems with the aging gastrointestinal tract - chapter 7
DESCRIPTION
Aging affects absorption and metabolism Diminished immune functionTRANSCRIPT
Problems with the Aging Gastrointestinal Tract
Chapter 7
The Gastrointestinal Tract
Insel P, Turner RE, Ross D. Discovering Nutrition. 3rd ed. Sudbury, MA: Jones & Bartlett; 2007, p. 112. Reproduced with permission.
Age-Related Changes in the Gastrointestinal Tract
• Aging affects absorption and metabolism • Diminished immune function
Gastrointestinal Tract Problemsin the Older Adult
• The Oral Cavity– Gum disease and tooth loss
• Teeth– Dental caries and periodontal disease– Methods for maintaining good oral health– Oral and throat cancers
Gastrointestinal Tract Problemsin the Older Adult
• Dysphagia– Multiple signs and symptoms
• Odonophagia– A three stage process
• Aspiration
Managing Dysphagia Symptoms
Gastrointestinal Tract Problemsin the Older Adult
• Aspiration (continued)– A complication of dysphagia and dysphasia– Can cause airway obstruction– Commonly results in pneumonia– Multifactorial management
• Salivation assists• Consistency of food is important
Gastrointestinal Tract Problemsin the Older Adult
• Esophagus• Heartburn• Gastroesophageal Reflux Disease
– Most common GI disorder affecting older adults– Symptoms should be treated
GERD Symptoms
Nonpharmacological methods of GERD Management
Medical Management of GERD
Upper Gastrointestinal Tract Problems
• Peptic Ulcer Disease– Gastric and duodenal ulcers– Commonly caused by Helicobacter pylori bacteria
and NSAIDs use– Complications
• Perforation• Hemorrhage
• Stress Ulcers
Upper Gastrointestinal Tract Problems
• Nausea and Vomiting– Evaluate for dehydration
• Gastroparesis– Delayed stomach emptying– Most commonly caused by Diabetes Mellitus– Management
• Nutrition modifications• Medication
Upper Gastrointestinal Tract Problems
• Malabsorption– Occurs when there is disruption in any phase of
digestion or absorption– Causes
• Pancreatic insufficiency• Anatomic abnormalities• Bacterial overgrowth syndrome• Pernicious anemia and B12 deficiency• Motility disorder• Other diseases
Upper Gastrointestinal Tract Problems
• Malabsorption– Signs: weight loss, diarrhea, steatorrhea,
abdominal bloating, and gas– Steatorrhea: malabsorption of fat– Maldigested carbohydrates– Treatment: Correct deficiencies and correct
underlying problems
Lower Gastrointestinal Tract Problems in Older Adults
• Antibiotic-Associated Enteritis– Clostridium difficile
• Lactose Intolerance (Hypolactasia)– Lactase splits lactose into monosaccharides– Lactose maldigestion– Lactose intolerance– Food sources: dairy and non-dairy sources
Lower Gastrointestinal Tract Problems in Older Adults
• Irritable Bowel Syndrome– More common in women and after age 35– A functional disorder– Treatment is used to reduce symptoms, manage
constipation and diarrhea, and other methods
Lower Gastrointestinal Tract Problems in Older Adults
• Intestinal Ischemia– Mesenteric Ischemia
National Institutes of Health, 2008
Lower Gastrointestinal Tract Problems in Older Adults
• Intestinal Ischemia– Acute intestinal
ischemia– Chronic intestinal
ischemia
Lower Gastrointestinal Tract Problems in Older Adults
• The role of Fiber in lower GI tract problems– Causative role in many dysfunctions– Is indigestible and softens stool– Lowers intracolonic pressure so stool is easy to
pass– ADA recommends 20-35 g/day
• Add high fiber foods gradually to diet
Lower Gastrointestinal Tract Problems in Older Adults
• Diverticulosis– Pouching out of the colon– Cause is low fiber diet
• Diverticulitis– If pouches become inflamed
Lower Gastrointestinal Tract problems in Older Adults
Reproduced from An Introduction to Human Disease, 7th ed. Photo courtesy of Leonard V. Crowley, M.D., Century College.
Lower Gastrointestinal Tract Problems in Older Adults
• Constipation– A symptom of a problem– This problem increases with age– More common in women– Causes
• IBS, inactivity, dehydration, drugs, low-fiber diet, certain medical conditions
Lower Gastrointestinal Tract Problems in Older Adults
Lower Gastrointestinal Tract problems in Older Adults
• Impaction– Occurs when chronic constipation is not managed
well• Diarrhea
– Bowel movements that are increased in number and frequency
– Fecal incontinence– Food poisoning and traveler’s diarrhea– Management: diet, smaller & more frequent
meals
Lower Gastrointestinal Tract Problems in Older Adults
• Fecal Incontinence– Inability to control bowel movements– Causes
• Constipation• Foods that contribute to diarrhea• Sphincter muscle damage• Nerve damage• Loss of storage capacity• Diarrhea• Pelvic floor dysfunction
Lower Gastrointestinal Tract Problems in Older Adults
• Hemorrhoids– Veins in anus and rectum are inflamed– Complications
• Fissures, abscesses, fistulae, itching– Maintain high-fiber diet and sufficient fluids– Surgical and non-surgical treatment
Gastrointestinal Tract Cancers
• Esophageal cancer– GERD is a risk factor– More likely in older men– Signs and symptoms
• Difficulty swallowing• Severe weight loss• Pain in throat• Chronic cough• Vomiting• Coughing up blood
Gastrointestinal Tract Cancers
Gastrointestinal Tract Cancers
• Stomach Cancer– Symptoms
• Indigestion, stomach discomfort– Treatment
• Variety of treatments
• Colorectal Cancer– Survival rate is poor– Emphasis on prevention