Effects of Aging on the Digestive System

By Atenodoro R. Ruiz, Jr., MD

Because the digestive system has a lot of reserve built into it, aging has less effect on its
function than it does on the function of other organ systems. Nonetheless, aging is a factor
in several digestive system disorders. In particular, older adults are more likely to develop
diverticulosis and to have digestive tract disorders (for example, constipation) as a side
effect of taking certain drugs.
Digestive System
The major functions of this system are the processing of food and the absorption of
nutrients, minerals, vitamins, and water.
Because of the large functional reserve capacity of most of the gastrointestinal (GI) tract,
aging has relatively little effect on GI functioning. The digestive system is made up of the
mouth, teeth, tongue, salivary glands, pharynx, esophagus, stomach, pancreas, liver,
gallbladder, large intestine, and small intestine. Essentially, normal digestion and absorption
occur in the elderly; however, there are many changes in the digestive system that parallel
the age-related changes seen in the other systems. Like other systems, the rate of new cell
growth declines and tissues become more susceptible to damage.
Due to a decrease in smooth muscle tone along a majority of the aging GI tract, food moves
through the system more slowly as the contractions necessary for the movement and
breakdown of food become weaker. Constipation becomes a problem along with
hemorrhoids. Weakening of the cardiac sphincter, a muscle that regulates the flow of food
from the esophagus into the stomach, can lead to esophageal reflux which causes heart
burn.
When toxins, such as alcohol and chemicals, are absorbed by the digestive tract and
transported to the liver for processing or storage, the liver cells are not immune to the
effects of these compounds. Chronic exposure leads to damage and disease in the liver and
many other organs.
With age, cancer rates increase, especially in the colon and stomach. Plus, changes in other
systems have direct and indirect effects on the digestive system. For example, the reduction
in bone mass and calcium content in the skeleton is associated with erosion of the tooth
sockets and tooth loss.

Esophagus
With age, the strength of esophageal contractions and the tension in the upper esophageal
sphincter decrease (called presbyesophagus), but the movement of food is not impaired by
these changes. However, many older adults are likely to be affected by diseases that
interfere with esophageal contractions.

Stomach
With age, the stomach lining's capacity to resist damage decreases, which in turn may
increase the risk of peptic ulcer disease, especially in people who use aspirin and other
nonsteroidal anti-inflammatory drugs (NSAIDs). Also with age, the stomach cannot
accommodate as much food (because of decreased elasticity), and the rate at which the
stomach empties food into the small intestine decreases. However, these changes typically
do not cause any noticeable symptoms. Aging has little effect on the secretion of stomach
juices such as acid and pepsin, but conditions that decrease acid secretion, such as atrophic
gastritis, become more common.
Small intestine
Aging has only minor effects on the structure of the small intestine, so movement of
contents through the small intestine and absorption of most nutrients do not change much.
However, lactase levels decrease, leading to intolerance of dairy products by many older
adults (lactose intolerance). Excessive growth of certain bacteria (bacterial overgrowth
syndrome) becomes more common with age and can lead to pain, bloating, and weight loss.
Bacterial overgrowth may also lead to decreased absorption of certain nutrients, such as
vitamin B

12

, iron, and calcium.

Pancreas, liver, and gallbladder

With age, the pancreas decreases in overall weight, and some tissue is replaced by scarring
(fibrosis). However, these changes do not decrease the ability of the pancreas to produce
digestive enzymes and sodium bicarbonate. As the liver and gallbladder age, a number of
structural and microscopic changes occur.
Large intestine and rectum
The large intestine does not undergo much change with age. The rectum does enlarge
somewhat. Constipation becomes more common which is caused by many factors:

A slight slowing in the movement of contents through the large intestine

A modest decrease in the contractions of the rectum when filled with stool

More frequent use of drugs that can cause constipation

Often less exercise or physical activity

Reference: http://www.msdmanuals.com/home/digestive-disorders/biology-of-the-digestivesystem/effects-of-aging-on-the-digestive-system