Lovat L B
Department of Medicine, Hammersmith Hospital, London.
Gut. 1996 Mar;38(3):306-9. doi: 10.1136/gut.38.3.306.
Few gastrointestinal functions decline to an important extent as a result of old age alone and there is little clinical evidence that significant malnutrition occurs in any normal elderly person as a result of the aging process itself. Nevertheless, decreased gastrointestinal reserve makes older people highly sensitive to minor insults and decompensation can rapidly occur. Drugs appreciably affect taste sensation, which is already blunted and psychological as well as physical disability can have a major impact on appetite. Malabsorption can be caused by gastric hypochlorhydria with small bowel bacterial overgrowth and while gastrointestinal dysmotility can be caused by subclinical hypothyroidism, it can improve in response to physical exercise. Evidence is now mounting that thorough investigation of gastrointestinal disturbances in elderly patients coupled with intensive nutritional support can make a very real impact on their outcome. Gastroenterologists should therefore seek out and actively treat gastrointestinal disorders in the elderly and not just ascribe them to old age.
很少有胃肠道功能仅因年老就出现显著衰退，而且几乎没有临床证据表明任何正常老年人会因衰老过程本身而发生严重营养不良。然而，胃肠道储备功能下降使老年人对轻微损伤高度敏感，且很快会出现失代偿。药物会明显影响味觉，而味觉本就已迟钝，心理和身体残疾也会对食欲产生重大影响。胃酸过少伴小肠细菌过度生长可导致吸收不良，虽然亚临床甲状腺功能减退可引起胃肠动力障碍，但体育锻炼可使其改善。现在越来越多的证据表明，对老年患者的胃肠道紊乱进行全面调查并给予强化营养支持，可切实改善其预后。因此，胃肠病学家应找出并积极治疗老年人的胃肠道疾病，而不应仅仅将其归因于年老。
