Geriatric Gastroenterology
The GI tract presents unique challenges to both the ageing patient and the clinician. The GI tract, which is approximately 30 feet long, is the largest immune organ as well as the largest endocrine organ in the body, contains more bacterial cells than human cells, has a dedicated nervous system that functions independently of the central nervous system, and has a complex muscular structure. The GI organs are in charge of food intake, the secretion of numerous enzymes and fluids, digestion, nutrient extraction and absorption, immune protection against infectious agents, immune tolerance of beneficial bacteria, and, finally, waste product excretion.
Elderly patients have a higher incidence of esophageal and gastric disorders, including motility abnormalities, gastroesophageal reflux, reflux complications (including Barrett's, dysplasia, and esophageal cancer), gastric ulcers, and GI bleeding. Lower GI diseases, such as pelvic floor disorders (and faecal incontinence), constipation, diarrheal illness, diverticular disease, inflammatory bowel disease, and colorectal cancer, also present more frequently and often atypically in the geriatric patient. Malnutrition and obesity are common problems in elderly patients.