TY - CHAP M1 - Book, Section TI - Gastrointestinal & Abdominal Complaints A1 - Hall, Karen E. A2 - Williams, Brie A. A2 - Chang, Anna A2 - Ahalt, Cyrus A2 - Chen, Helen A2 - Conant, Rebecca A2 - Landefeld, C. Seth A2 - Ritchie, Christine A2 - Yukawa, Michi PY - 2014 T2 - Current Diagnosis & Treatment: Geriatrics, 2e AB - According to data from the U.S. Census Bureau in 2005, 45–50 million people older than age 65 years had at least 1 gastrointestinal (GI) complaint that impacted their daily life and that could result in a medical visit. GI symptoms are common in older adults and range from mild self-limited episodes of constipation or acid reflux to life-threatening episodes of infectious colitis or bowel ischemia. In addition to the increased prevalence of diseases such as diverticulitis and colon cancer in older patients, other common comorbidities, such as pain requiring nonsteroidal antiinflammatory drug use or atrial fibrillation requiring use of anticoagulants, increase the risk of GI complications such as ulceration or bleeding. Patients may present with unusual or subtle symptoms of serious GI disease caused by alterations in physiology with aging. An example of this is seen in older patients presenting with a GI perforation or colitis who do not have guarding or significant abdominal tenderness as a result of the decrease in visceral sensitivity that accompanies aging. Changes in the neuromuscular control of the colon with aging appear to predispose to constipation, thus explaining the increased prevalence of constipation and impaction developing with bed rest or use of constipating medications. SN - PB - McGraw-Hill Education CY - New York, NY Y2 - 2024/04/19 UR - accessmedicine.mhmedical.com/content.aspx?aid=1100067499 ER -