Aging & the Gastrointestinal System 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.

Normal changes to the Oral Cavity 3-15-05 Normal changes to the Oral Cavity  saliva production Atrophy of taste buds *********  taste sensation

Normal Changes to the Esophagus 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

Normal Changes to the Stomach 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

Normal Changes to the Stomach 3-15-05 Normal Changes to the Stomach Physiological changes:  digestion  absorption ******** Drug solubility & absorption might be altered

Normal Changes to the Small & Large Intestines 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

Normal Changes to the Small & Large Intestines 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

Normal Changes to the Liver 3-15-05 Normal Changes to the Liver Liver  overall liver weight, mass  hepatic cells  regenerative capacity  blood flow to liver  hepatic enzymes

Normal Changes to the Liver 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 drug-induced liver disorders  hormone metabolism

Normal GI Changes Gallbladder, bile ducts, Pancreas 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

Normal GI Changes Gallbladder, bile ducts, Pancreas (cont’d) 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

Normal GI Changes Nursing considerations 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