Digestive Challenges as We Age
As individuals age, they often experience increased sensitivity in their digestive systems. While aging brings various surprises—such as the creaking of joints and unexpected hangovers after minimal drinking—one of the more disheartening changes is a decline in digestive efficiency.
“Intestinal issues can arise at any age and can become more prevalent as we age,”
said Dr. Sara Attalla, a gastroenterologist at Inspira Health in New Jersey. The National Institutes of Health estimates that between 60 million and 70 million Americans suffer from digestive diseases, manifesting symptoms such as heartburn, bloating, abdominal pain, and irregular bowel habits like constipation and diarrhea.
Identifying the root causes of these digestive issues can be complex, as they often stem from a combination of individual aging factors and lifestyle choices.
The Impact of Aging on Digestion
With age, the nerves and muscles in the gastrointestinal (GI) tract can become less effective, leading to changes in how digestive organs function both individually and in coordination with one another. This can slow the overall digestion process and disrupt communication signals between these organs.
For instance, swallowing may become harder as esophageal movement and muscle coordination decline, increasing the likelihood of gastroesophageal reflux disease (GERD). Furthermore, decreased gastric motility can lead to food lingering in the stomach, promoting indigestion.
“The stomach lining can also become thinner with age, which renders you more susceptible to injury in the stomach from things like inflammation,”
Attalla noted. Additionally, a decline in prostaglandin production, which helps regulate stomach acid secretion, can weaken the stomach’s protective lining, increasing the risk for conditions like gastritis and ulcers.
The small intestine can also experience slower motility, which may lead to bacterial overgrowth, according to Dr. Sunana Sohi, a board-certified gastroenterologist at Gastroenterology Health Partners in Louisville, Kentucky. This can result in symptoms like bloating and diarrhea.
If motility halts in the colon, individuals may face constipation and diverticulosis, a condition where pouches form in the colon walls, raising the risks of complications such as bleeding and inflammation.
Chronic illnesses, including arthritis and cardiovascular diseases, often accompany aging and can restrict physical activity. Lack of movement may further hinder gut motility. “If you don’t move, neither does your gut,”
said Dr. Pritesh Mutha, an associate professor at McGovern Medical School at UTHealth Houston.
Additionally, many medications used to manage these conditions, such as NSAIDs like aspirin and ibuprofen, can contribute to digestive side effects, including nausea, constipation, and abdominal pain.
Strategies for Improving Digestion in Older Age
While these digestive changes can be disheartening, experts suggest several strategies to alleviate age-related digestive issues:
1. Chew Thoroughly
Effective digestion begins in the mouth. “Salivary enzymes help digest starch and fat in the mouth, decreasing the GI tract’s workload,”
Mutha explained. “The alkaline pH of saliva also helps neutralize acid in the esophagus due to reflux and alleviate GERD symptoms.”
Chewing food into smaller pieces and aiming for 15 to 20 chews per bite can be beneficial.
2. Stimulate Saliva Production
With age, saliva production tends to diminish, affecting chewing and swallowing. The American Dental Association states that dry mouth is more likely for those taking daily medications. Utilizing over-the-counter saliva substitutes and sipping water during meals can improve comfort.
3. Focus on Plant-Based Foods
A diet that minimizes processed foods while maximizing plant-based options can optimize digestion. “Diets high in processed food can alter the gut microbiome, leading to dysbiosis,”
Sohi noted. “Going plant-based is the best way to increase your fiber intake.”
Fiber improves bowel consistency and quantity, enhancing overall digestive health.
4. Stay Hydrated
Proper hydration is crucial for preventing constipation, particularly with increased fiber intake. The National Council on Aging recommends drinking one-third of your weight in fluid ounces daily.
5. Increase Physical Activity
Regular movement stimulates GI tract motility. “Lying recumbent on the couch after eating is one of the worst things you can do because it can promote acid reflux,”
Sohi emphasized.
Post-meal walks of about 15 minutes can enhance digestion and gastric emptying.
6. Prioritize Sleep
Quality sleep, ideally seven to nine hours nightly, supports digestive health. Lack of sleep may contribute to increased bowel inflammation, leading to gastrointestinal issues.
7. Manage Medications
“Any and every medicine has GI side effects,”
Mutha cautioned. “Making sure you take your medications exactly as prescribed decreases the risk of side effects.”
He advises against taking NSAIDs on an empty stomach and scheduling acid-suppressive medications prior to breakfast.
When to Consult a Physician
While it can be easy to attribute digestive disturbances to aging or lifestyle choices, Dr. Neena Mohan, gastroenterologist and assistant professor of clinical medicine at the Lewis Katz School of Medicine at Temple University in Philadelphia, urges individuals not to dismiss their symptoms. “It’s important to not assume” and to discuss any concerns with a doctor, as there may be more serious underlying conditions.
If symptoms persist—such as changes in bowel habits along with trouble swallowing, abdominal pain, nausea, unexplained weight loss, or blood in stools—consulting a gastroenterologist is crucial. “Depending on the issue, your doctor may start with bloodwork and prescribe medications or conduct further testing, such as an endoscopy or colonoscopy,”
Attalla indicated.
