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3-15-05 Aging & the Gastrointestinal System Content for this module provided by The John A. Hartford Foundation, Institute for Geriatric Nursing, Online Gerontological Nursing Certification Review Course http://www.nyu.edu/education/nursing/hartford.institute/course/ Support for this project provided to School of Nursing, University of Washington by the John A. Hartford Foundation, Geriatric Nursing Education Grant and Nursing School Geriatric Investment Program Grant. 3-15-05 Normal changes to the Oral Cavity • saliva production • Atrophy of taste buds ********* taste sensation 3-15-05 Normal Changes to the Esophagus Anatomical • Degenerative change in smooth muscle lining lower esophagus • Slower, weaker peristalsis • resting pressure of LES Physiological • potential for stomach content reflux into lower esophagus 3-15-05 Normal Changes to the Stomach Anatomical changes • elasticity • motility • gastric surface area • gastric secretions • Atrophy of gastric mucosa • Slowing of stomach emptying 3-15-05 Normal Changes to the Stomach Physiological changes: • digestion • absorption ******** Drug solubility & absorption might be altered 3-15-05 Normal Changes to the Small & Large Intestines Anatomical changes • secretion of digestive enzymes • elasticity of rectal wall • internal anal sphincter tone • mucus secretion • Atrophy of muscle & mucosal surfaces • Thinning of villi, epithelial cells 3-15-05 Normal Changes to the Small & Large Intestines Physiological • Potential absorption of fats and vitamin B12 • Slower and dulled neural impulses that sense urge to defecate ******** Potential for bowl incontinence, incomplete emptying, constipation 3-15-05 Normal Changes to the Liver Liver • overall liver weight, mass – hepatic cells • regenerative capacity • blood flow to liver • hepatic enzymes 3-15-05 Normal Changes to the Liver Liver • Enzyme changes result in drug clearance – May require individualized medication management – Polypharmacy, increased drug use, & advancing age result in increased vulnerability to druginduced liver disorders • hormone metabolism 3-15-05 Normal GI Changes Gallbladder, bile ducts, Pancreas • No significant changes in structure & function of gallbladder – bile storage – Length of bile ducts widen • End of common bile duct narrows (near small intestine) • Pancreatic ductal hyperplasia, fibrosis 3-15-05 Normal GI Changes Gallbladder, bile ducts, Pancreas (cont’d) • pancreatic enzyme secretion • bile salt pool • Potential for fat digestion ********* Vague intolerance to fatty foods 3-15-05 Normal GI Changes Functional implications • No significant functional effects associated with age • Common complaints: – – – – – – – – fullness dysphagia heartburn vomiting sternal pain (differentiate from CV problem) decreased appetite constipation fecal incontinence 3-15-05 Normal GI Changes Nursing considerations • No clear-cut GI diseases can be attributed directly to the aging process • GI-related symptoms should not be dismissed as part of the normal aging process • General care should include primary & secondary prevention of GI tract problems • Increased risk of colon cancer over age 50
