1. Aging & the Gastrointestinal System
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
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.

2. Normal changes to the Oral Cavity
Normal changes to the Oral Cavity
 saliva production
Atrophy of taste buds
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 taste sensation

3. Normal Changes to the Esophagus
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

4. Normal Changes to the Stomach
Normal Changes to the Stomach
Anatomical changes
 elasticity
 motility
 gastric surface area
 gastric secretions
Atrophy of gastric mucosa
Slowing of stomach emptying

5. Normal Changes to the Stomach
Normal Changes to the Stomach
Physiological changes:
 digestion
 absorption
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Drug solubility & absorption might be altered

6. Normal Changes to the Small & Large Intestines
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

7. Normal Changes to the Small & Large Intestines
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
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Potential for bowl incontinence, incomplete emptying, constipation

8. Normal Changes to the Liver
Normal Changes to the Liver
Liver
 overall liver weight, mass
 hepatic cells
 regenerative capacity
 blood flow to liver
 hepatic enzymes

9. Normal Changes to the Liver
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

10. Normal GI Changes Gallbladder, bile ducts, Pancreas
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

11. Normal GI Changes Gallbladder, bile ducts, Pancreas (cont’d)
Normal GI Changes
Gallbladder, bile ducts, Pancreas
(cont’d)
 pancreatic enzyme secretion
 bile salt pool
Potential for  fat digestion
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Vague intolerance to fatty foods

12.
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

13. Normal GI Changes Nursing considerations
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