RT Book, Section
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
SR Print(0)
ID 1100067499
T1 Gastrointestinal & Abdominal Complaints
T2 Current Diagnosis & Treatment: Geriatrics, 2e
YR 2014
FD 2014
PB McGraw-Hill Education
PP New York, NY
SN 978-0-07-179208-0
LK accessmedicine.mhmedical.com/content.aspx?aid=1100067499
RD 2024/04/25
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.