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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.
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Normal changes to the Oral Cavity
• saliva production
• Atrophy of taste buds
********* taste sensation
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Anatomical • Degenerative change in smooth muscle lining lower esophagus
• Slower, weaker peristalsis
Normal Changes to the Esophagus
• resting pressure of LES Physiological
• potential for stomach content reflux into lower esophagus
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Anatomical changes • elasticity
• motility
Normal Changes to the Stomach
• gastric surface area
• gastric secretions
• Atrophy of gastric mucosa
• Slowing of stomach emptying
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Normal Changes to the Stomach
Physiological changes: • digestion
• absorption
********
Drug solubility & absorption might be altered
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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
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Physiological • Potential absorption of fats and vitamin B12
• Slower and dulled neural impulses that sense urge to defecate
Normal Changes to the Small & Large Intestines
******** Potential for bowl incontinence, incomplete emptying, constipation
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Normal Changes to the Liver
Liver • overall liver weight, mass
– hepatic cells
• regenerative capacity
• blood flow to liver
• hepatic enzymes
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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
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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
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Normal GI Changes
Gallbladder, bile ducts, Pancreas (cont’d)
• pancreatic enzyme secretion
• bile salt pool • Potential for fat digestion
*********
Vague intolerance to fatty foods
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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
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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