Aging and Digestive Health

From the WebMD Archives

Getting older has pluses and minuses. On the plus side, you get more time to relax and enjoy life. On the minus side lie many health challenges -- including an increase in digestive health disorders. Of course, problems with digestion can occur at any age. Yet nearly 40% of older adults have one or more age-related digestive symptom each year.

Here's an overview of common digestive health problems that may arise with age. Learn why they occur and what you can do to keep your digestive system running smoothly well into your later years.

Digestive Problems as You Age

  • Constipation. One of the most common things we see, certainly as people are getting into their 60s and 70s, may be a change in bowel habits, predominantly more constipation," says Ira Hanan, MD, associate professor of medicine at the University of Chicago Medical Center. Symptoms include difficult or painful bowel movements, infrequent bowel movements, and hard, dry stool. There are a number of age-related factors that can cause constipation in older adults.
  • Changes in the digestive system. Your digestive system moves food through your body by a series of muscle contractions. Just like squeezing a toothpaste tube, these contractions push food along your digestive tract, Hanan says. As we age, this process sometimes slows down, and this can cause food to move more slowly through the colon. When things slow down, more water gets absorbed from food waste, which can cause constipation.
  • Medication use. Older adults take a lot of medications, says Ellen Stein, MD, an assistant professor of medicine at Johns Hopkins Hospital in Baltimore, MD. And as we age, we start to have more health problems that require medications. Several common medications can cause constipation. One example is calcium channel blockers, used for high blood pressure. "Very good for blood pressure, very constipation causing," says Stein. Narcotic pain relievers are another common culprit. An older adult who has knee or hip replacement surgery will often be given narcotics for pain. "Narcotics have effects directly on the bowel," Stein tells Web MD. "They actually slow the gut."
  • Inactivity. People often become less active as they age, says Stein, and being inactive can make you constipated. Bed rest during an illness can cause real problems. If a person has joint-replacement surgery, for example, it takes time to recover and be fully active again. Add narcotic pain relievers to the mix, and "that might change manageable constipation into something that's much more of a problem," Stein says.
  • Not drinking enough fluids. Staying hydrated helps prevent constipation at any age. It can become more of an issue for older adults who take diuretics for high blood pressure or heart failure. Diuretics lower blood pressure by causing you to lose excess fluid by urinating more often. Some people may avoid drinking too many fluids so they don't have to run to the bathroom all day long. Between urinating more and drinking less, you can become dehydrated.
  • Diverticular Disease. About half of people age 60 and older have diverticulosis. This occurs when small pouches in the lining of the colon bulge out along weak spots in the intestinal wall. While many people don't have any symptoms, gas, bloating, cramps, and constipation may occur. "I tell my patients its part of the aging of the colon," Hanan tells WebMD. "As we get older, we're more prone to developing these pockets." Why they occur with age is unclear, he says. While most of the time they don't cause a problem and don't require treatment, they can cause scarring and irregularity. If the pockets become inflamed, it's called diverticulitis, which can cause abdominal pain, cramping, fever, chills, nausea, and vomiting. Antibiotics, pain medications, and a liquid diet treat diverticulitis.
  • Ulcers &NSAIDs. Many older adults use nonsteroidal anti-inflammatory drugs (NSAIDs) to control pain from arthritis and other types of chronic pain. Regular use of NSAIDs increases the risk for stomach bleeding and ulcers. So while aging alone doesn't make your stomach more prone to ulcers, the chronic use of NSAIDs does raise your risk. More often than not older patients don't have pain from ulcers, says Hanan, but they can have painless gastrointestinal (GI) bleeding. If you notice any type of stomach bleeding, such as vomiting blood, passing dark stools, or noticing blood when you wipe, tell your doctor right away.
  • Problems with the mouth and esophagus. The esophagus is the tube that connects our mouth to our stomach. Like the colon, the esophagus can also slow down with age, moving food through more slowly. This can cause problems swallowing food or fluids. Dementia, stroke, and conditions such as Parkinson's disease can also cause difficulty swallowing.
  • Polyps. After age 50, the risk increases for developing polyps, or small growths, in the colon. Polyps may be noncancerous, they may become cancer, or they may be cancer. "We don't know what causes polyps," Hanan says. There's been speculation that it's something in the diet or something we don't get enough of, plus genetics. It's probably a cumulative effect over the years, he says. You can have polyps and not know it because they usually don't have any symptoms. "That's why screening colonoscopies are recommended for anyone over the age of 50," Hanan tells WebMD. During this procedure, polyps can be removed before they become cancer. People with a family history of colon cancer or other risk factors may need to have screenings earlier.
  • GERD. Gastroesophageal reflux disease (GERD) is the most common upper GI disorder in older adults, although people of all ages can get it. GERD occurs when stomach acid backs up into the esophagus, causing heartburn and other symptoms. Heartburn is more common as you get older, says Stein, but it's often caused by factors not related to aging. Eating late at night and eating the wrong types of foods, such as fast food and fried foods, can all cause reflux. Certain medications, including some blood pressure medications, which many older adults take, can cause heartburn. Obesity increases your risk for heartburn and GERD, so if you gain weight as you get older, you could have more reflux.

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How to Protect Your Digestive Health as You Age

Just like any other health problem, prevention is the best medicine when it comes to keeping your digestion running smoothly. "The things that are good for all older Americans are really good for the gut," Stein tells WebMD. These tips can help you protect your digestive health and your overall well-being.

  • Check your meds. Stein and Hanan recommend using medications with care. Talk with your doctor to see if your medications could be causing any digestive symptoms. If you use NSAIDs for pain, work with your doctor to find the lowest effective dose, and be sure to take them with food. Also check with your doctor to make sure you are taking only the medications you need.
  • Stay active. Getting at least 30 minutes of exercise 5 days week can help prevent many age-related health problems. It will also help keep you regular and decrease the risk for colon cancer.
  • Eat more fiber. Foods high in fiber, including fruits and vegetable, whole grains, and beans also tend to be high in nutrients and low in fat. High-fiber foods can help prevent constipation and ease symptoms of diverticulosis.
  • Drink plenty of fluids. Drink plenty of fluids throughout the day. Drink enough so that you don't feel thirsty. If you are taking diuretics, talk with your doctor about ways to manage taking your medication so that you don't become dehydrated.
  • Manage your weight. Maintaining a healthy weight can help prevent many age-related health problems such as heart disease, diabetes, and high blood pressure. Avoiding health problems can reduce the number of medications you need to take, which means less worry about digestive side effects. Limiting the fat in your diet, choosing healthy portions, and choosing whole foods instead of processed foods will all help you manage your weight more easily.
  • Get regular health screenings. Be sure to tell your doctor about any troublesome symptoms and ask about regular screenings.
WebMD Feature Reviewed by Andrew Seibert, MD on May 08, 2012

Sources

SOURCES:

Ira Hanan, MD, associate professor of medicine at the University of Chicago Medical Center.

G. Richard Locke III, M.D., gastroenterologist with the Mayo Clinic in Rochester, MN.

Ellen Stein, MD, assistant professor of medicine at Johns Hopkins Hospital in Baltimore, MD.

Johns Hopkins Health Alerts: "Your Aging Digestive System."

Merck Manual: "Effects of Aging on the Digestive System."

American Gastroenterological Association: "Understanding Constipation."

National Digestive Diseases Information Clearinghouse: "Constipation."

Medline Plus: "Fluids and Diuretics."

National Heart, Lung, and Blood Institute: "How Is High Blood Pressure Treated?"

HeartHealthyWomen.org: "Diuretics and Heart Failure."

National Digestive Diseases Clearinghouse: "Diverticulosis and Diverticulitis."

Z. Marcum. Annals of Long-Term Care: Clinical Care and Aging, 2010; vol. 18, no. 9

National Digestive Diseases Clearinghouse: "What I Need to Know About Colon Polyps."

CDC: "Physical Activity Guidelines."

Cancer.gov: "Colorectal Cancer Prevention."

FamilyDoctor.org: "Fiber: How to Increase the Amount in Your Diet."

CDC: "Losing Weight."

Choose My Plate.gov: "Let's Eat for the Health of It."

M. Chait. World Journal of Gastrointestinal Endoscopy, December 16, 2010.

© 2012 WebMD, LLC. All rights reserved.

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