Division of Hospital Medicine, Mayo Clinic Health System, Eau Claire, WI, USA.
Mayo Clinic College of Medicine and Sciences, Rochester, MN, USA.
Can J Gastroenterol Hepatol. 2019 Jan 17;2019:6757524. doi: 10.1155/2019/6757524. eCollection 2019.
Considering an increase in the life expectancy leading to a rise in the elderly population, it is important to recognize the changes that occur along the process of aging. Gastrointestinal (GI) changes in the elderly are common, and despite some GI disorders being more prevalent in the elderly, there is no GI disease that is limited to this age group. While some changes associated with aging GI system are physiologic, others are pathological and particularly more prevalent among those above age 65 years. This article reviews the most important GI disorders in the elderly that clinicians encounter on a daily basis. We highlight age-related changes of the oral cavity, esophagus, stomach, small and large bowels, and the clinical implications of these changes. We review epidemiology and pathophysiology of common diseases, especially as they relate to clinical manifestation in elderly. Details regarding management of specific disease are discussed in detail if they significantly differ from the management for younger groups or if they are associated with significant challenges due to side effects or polypharmacy. Cancers of GI tract are not included in the scope of this article.
考虑到预期寿命的增加导致老年人口的增加,认识到衰老过程中发生的变化是很重要的。老年人的胃肠道(GI)变化很常见,尽管一些胃肠道疾病在老年人中更为普遍,但没有一种胃肠道疾病仅限于这个年龄段。虽然与衰老的胃肠道系统相关的一些变化是生理性的,但其他变化是病理性的,特别是在 65 岁以上的人群中更为普遍。本文综述了临床医生日常遇到的老年人中最重要的胃肠道疾病。我们强调了与年龄相关的口腔、食管、胃、小肠和大肠的变化,以及这些变化的临床意义。我们回顾了常见疾病的流行病学和病理生理学,特别是它们与老年人临床表现的关系。如果特定疾病的治疗方法与年轻人群显著不同,或者由于副作用或多药治疗而存在显著挑战,则详细讨论了特定疾病的治疗细节。本文不包括胃肠道癌症。