HOW DOES THE GASTROINTESTINAL SYSTEM CHANGE WITH AGE?

Due to its considerable reserve capacity, the gastrointestinal system is better insulated from the effects of aging than other organ systems in the body. Changes to the gastrointestinal system generally consist of a decrease or slowing of functions and an increased risk of digestive tract disorders.

The gastrointestinal system extends from the mouth to the anus and includes the throat, esophagus, stomach, and intestines. It is responsible for breaking down food into nutrients, absorbing the nutrients into the bloodstream, and eliminating waste from the body.

It remains relatively stable until approximately age 65, according to a 2010 study in Italy, after which age-related changes begin to have an effect. For example, you might begin to notice the following changes to the different parts of the gastrointestinal system:

• In the mouth, less saliva and decreased force from jaw muscles can cause difficulty in chewing or swallowing.
• In the esophagus, the strength of esophageal contractions and the tension in the upper esophageal sphincter decrease.
• Changes to the stomach lining causes it to lose elasticity with can decrease its ability to resist damage, increasing the risk of ulcers, as well as not being able to accommodate as much food.
• A decrease in lactase levels in the small intestine often leads to an intolerance of dairy products, and excessive growth of certain bacteria can lead to decreased absorption of certain nutrients, such as vitamin B12, iron, and calcium.
• A slight slowing of movement of contents through the large intestine.
• The rectum enlarges somewhat and constipation becomes more common due to a decrease in contractions when the rectum is filled with stool.

WHAT DO THESE CHANGES MEAN FOR YOUR HEALTH?

From age 65 on, gastrointestinal symptoms can be quite common and range from mild constipation or acid reflux to more serious conditions like infectious colitis or bowel ischemia. Older adults are also more likely to use medications, such as certain heart medications or nonsteroidal anti-inflammatory drugs to treat chronic pain, that can increase the risk of gastrointestinal ulceration or bleeding.

Risk of developing colon cancer or diverticulitis also increases with age. Diverticula are small sac-like out-pouchings of the colon lining that balloon through the outer colon wall, occurring most frequently in the lower section of the colon. Occurrence of diverticular disease rises sharply from 5% in those 40 or younger, to at least 50% in older adults aged 65 or older.

HOW DO I KEEP MY GASTROINTESTINAL SYSTEM HEALTHY?

You can help keep your gastrointestinal system healthy and reduce the risk of digestive tract disorders by maintaining healthy dietary habits. For example, choose nutritious foods, follow a balanced diet, and limit dairy, red and processed meats, and refined sugars. Getting enough fibre is important to help avoid constipation, diarrhea, and diverticular disease, while Vitamin B12 and D, calcium, and iron supplements may be needed to meet daily recommendations.

Drinking lots of water, keeping physically active and getting enough sleep help maintain both overall and digestive health. It’s also important to speak to your health care practitioner regarding any concerning symptoms. To determine the health of your gastrointestinal system, your doctor may perform a physical exam or order lab tests and imaging to investigate the cause for symptoms.

Imaging could include an ultrasound of the various parts of the gastrointestinal system, MRI, or CT imaging of the colon, called virtual colonoscopy. For more information, please visit our services page.

REFERENCES

Gastrointestinal Society (2020) “Aging Digestive Tract.” www.badgut.org. Accessed June 5, 2022.

Halter, J. B., et al (2017) “Chapter 90: Aging of the Gastrointestinal System.” Hazzard’s Geriatric Medicine and Gerontology, 7th edition.

Rémond, D., et al (2015) “Understanding the gastrointestinal tract of the elderly to develop dietary solutions that prevent malnutrition.” Oncotarget. Jun 10; 6(16): 13858–98. Accessed June 5, 2022.

Ruiz, A. R. (2022) “Effects of Aging on the Digestive System.” Merck Manual Consumer Version. www.merckmanuals.com. Accessed June 5, 2022.