The Aging Gut

Abstract

This brief review addresses the changes that occur in the gut in the elderly and discusses the clinical implications of these changes.  This review addresses the changes that occur in the stomach, small bowel, gut microbes and the colon in old age and examines its effect on clinical presentation. The gastric dysmotility and hypochlorhydria contribute to anorexia and anaemia. Small bowel disease in the elderly almost always denotes organic disease. The effect of old age on the colon is due dysmotility and presents as constipation and its sequelae like faecal impaction and faecal incontinence. The changes in the microbiota can interact with the immune system and leads to a condition termed “inflamm-ageing.†Comorbidities influence the clinical presentation in old age. Diabetes, hypothyroidism and Parkinsonism are some examples. The increased usage of drugs also influences the gut – some examples being calcium channel blockers, antispasmodics, anti-hypertensives and drugs used in Parkinsonism. The paper highlights the coexistence of many diseases in the elderly. In a person presenting with bleeding PR, the search should not end once a source of bleeding like haemorrhoids is identified. This paper stresses the fact that organic diseases, like colon cancer, are more common in the elderly and that caution should be exercised in attributing a symptom just to old age.