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The clinical significance of gastrointestinal changes with aging

Bhutto, Asifa; Morley, John Ea,b

Current Opinion in Clinical Nutrition and Metabolic Care: September 2008 - Volume 11 - Issue 5 - p 651–660
doi: 10.1097/MCO.0b013e32830b5d37
Nutrition and the gastrointestinal tract: Edited by Maria Isabel Toulson Davisson Correia and Herbert Lochs

Purpose of review With the graying of the world's population, there is an increased interest in the physiological effects of aging. This review examines the physiological changes of the gut with aging and their clinical significance.

Recent findings Changes with aging in the gastrointestinal tract are variable, but in some cases they are responsible for a variety of symptoms. Thus, alterations in taste and smell, gastric motility, intestinal overgrowth and changes in gastrointestinal hormone release are the basis of the physiological anorexia of aging. Alterations in swallowing lead to silent aspiration. Changes in gastric emptying play a role in postprandial hypotension. Changes in gastrointestinal function can lead to constipation and fecal incontinence. Weakening of the colonic muscular wall produces diverticula. Achlorhydria is associated with malabsorption of some forms of iron and calcium. Vitamin D malabsorption aggravates the hypovitaminosis D that is so common in older persons. Changes in probiotics can lead to diarrhea and altered immune system. In the liver, aging is associated with delayed drug metabolism.

Summary Changes in the physiology of the gut play a role in the anorexia of aging, aspiration pneumonia, postprandial hypotension, constipation and fecal incontinence.

aDivision of Geriatric Medicine, Saint Louis University, USA

bGRECC, VA Medical Center, St. Louis, Missouri, USA

Correspondence to John E. Morley, MB, BCh, Geriatric Medicine, 1402 South Grand Boulevard, M238 St. Louis, MO 63104, USA E-mail:

© 2008 Lippincott Williams & Wilkins, Inc.