The Ageing GI Tract

Question 1

How does the Nose and Mouth change?

How does the Oesophagus change?

How does the Stomach change?

How does the Small Intestine change?

How does the Large Intestine change?

How does the Liver change?

How does the Pancreas change?

Answer 1

• • ↓Sense of smell and taste
  • Gum recession
  • Difficulty swallowing
• • ↓Peristalsis
  • Oesophageal sphincters lose tension
• • ↓Elasticity of its wall
  • ↓Bicarbonate production and mucous secretion
  • Delayed gastric emptying
• Compromised gut-associated lymphoid tissue
• • Slower Peristalsis - Takes longer to reach rectum
  • ↓Cell division and lining repair
  • Changes in microbial fauna and epithelial cell DNA
• • Shrinks - ↓Hepatocytes
  • ↓Ability to detoxify substances
  • Changes in bile composition
• ↓Pancreatic protease and Lipase secretion

Question 2

CONSTIPATION:
What is it?

What non-pharmacological methods are recommended for it?

What are the 4 types of Laxatives? What do they do?

What are the complications that can occur with it?

Answer 2

• Passing of hard stool <1 every 3 days - Difficult to evacuate and feeling of incomplete evacuation
• Increase fibre intake, take enough fluid, maintain mobility, regular toileting
• • Bulk-forming - Increases bulk of stool by retaining fluid, and this increase in mass stimulates peristalsis
  • Osmotic - Softens stool by increasing the water in the bowels
  • Stimulant Bisacodyl/Senna - Stimulates nerves that control the muscles of the gut
  • Stool softener - Makes the surface of the stool permeable for water to be absorbed and for it to become softer
• Urinary retention, Bowel obstruction, Faecal impaction, Diarrhoea, Bowel perforation (rare)

Question 3

FAECAL INCONTINENCE:
What can cause it?

How is it managed?

Answer 3

• Structural anorectal abnormalities, Neurological abnormalities, Cognitive disfunction, Age, Acute illness, Idiopathic
• Set a regular pattern of toileting, Pelvic floor exercises