Gastrointestinal disorders in elderly patients

Gastrointestinal (GI) diseases are common in older patients, and the clinical presentation, complications, and treatment may be different from those in younger patients. With the marked increase in population aged 65 years and over, the study and care of GI disorders should be a high priority for both clinicians and researchers. Both the usual course of aging and the accumulation of multiple disease states can lead to impairments in GI function. Older individuals’ propensity to use multiple medications, combined with years of acquired lifestyle choices, can disrupt the integrity and functioning of the GI system. Most problems encountered occur at the proximal and distal ends of the GI tract.1,2 Constipation is the most common GI complaint in of one quarter of elderly men and one third of elderly women.3 Acute abdomen in elderly patients poses a difficult challenge for emergency physicians. Elderly patients have a diminished sensorium, allowing pathology to advance to a very dangerous state before developing symptoms. In the presence of serious intra-abdominal pathology, elderly patients are more likely to present with vague symptoms and to have nonspecific findings on examination. Mesenteric ischemia and small bowel obstruction (SBO)must be included in the initial differential diagnosis of abdominal pain, because an early diagnosis minimizes the risk of an unfortunate outcome.4