Digestive symptoms increasingly common in older adults

Aging affects all the digestive functions and this is due to the natural changes affecting the gastrointestinal (GI) tract. Several factors contribute to changes in the GI tract, including reduced production of digestive enzymes, slower muscle contractions, changes in gut bacteria composition and side effects from medications, said Dr Lim Sim Yee, a consultant in gastroenterology and hepatology, and Dr Soon Yuen, a consultant general and upper gastrointestinal surgeon.

Nearly 40 percent of older adults have one or more age-related digestive symptoms each year. [J Clin Gastroenterol 2016;50(10):819–827] Furthermore, those with existing or long-standing digestive conditions can experience worsening symptoms as they age. Nevertheless, it is important to observe and investigate digestive issues, if needed, and not entirely link them to aging as the issues may indicate underlying medical conditions such as colon cancer, they added. Some digestive conditions due to age-related changes include constipation, heartburn, diverticulosis, and lactose intolerance.

“One of the most important changes an aging person can make to not only make a difference to their digestive system but also on their overall health is increasing protein intake to 1.5 grams per kilogram of body weight and incorporating more fresh fruits and vegetables, fiber, and lean meat in their diet. This is because as we age, we lose muscle,” said Soon.

In the aging process, people usually lose about 16 percent to 40 percent of muscle mass beyond the age of 40. [Muscles Ligaments Tendons J 2013;3(4):346–350] Aging-related muscle loss affects both men and women. Soon shared that his 93-year-old father’s routine of walking 3,500 steps or 1.6 kilometers daily is an example of the effects of consistent exercise in the aging population.

Chronic conditions such as diabetes mellitus are related to worsening of digestive issues during the aging process. High blood glucose levels among those with diabetes can cause gastroparesis and alter their gut movements. Prescribed medications are also often a crucial aspect since they can have side effects that can cause constipation and other digestive issues. A collaborative effort between patients and healthcare professionals is essential in deciphering the potential interplay between various medications, ensuring a tailored and effective treatment plan, said Lim.

According to Soon, older people are at an increased risk of gastric ulcers and gastritis due to the waning of protective mechanisms. One of the causes is Helicobacter pylori, which is classified as a Class I carcinogen by the World Health Organization (WHO). Also, the prevalence of H. pylori in older people has been shown to be significantly higher compared to younger people. As a result, a higher incidence of gastric cancer, peptic ulcer disease and other H. pylori-associated conditions have been noted in older people. [Sci Rep 2023;13:18821]

Both Lim and Soon emphasized the importance of proactive healthcare and addressing health concerns promptly. Lim noted that “many digestive issues can be treated easily if addressed promptly.” Soon added that older people should be advised to enjoy their life and seek medical attention early if they have any concerns. He cautioned against self-diagnosis through online platforms as it can worsen the problem, especially for older people who might dismiss their symptoms as part and parcel of aging.