Transcript Anatomical changes - University of Washington School of Nursing

3-15-05
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
http://www.nyu.edu/education/nursing/hartford.institute/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.
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Normal changes to the
Oral Cavity
•  saliva production
• Atrophy of taste buds
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 taste sensation
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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
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Normal Changes to the
Stomach
Anatomical changes
•  elasticity
•  motility
•  gastric surface area
•  gastric secretions
• Atrophy of gastric mucosa
• Slowing of stomach emptying
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Normal Changes to the
Stomach
Physiological changes:
•  digestion
•  absorption
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Drug solubility & absorption
might be altered
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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
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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
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Normal Changes to the Liver
Liver
•  overall liver weight, mass
–  hepatic cells
•  regenerative capacity
•  blood flow to liver
•  hepatic enzymes
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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 druginduced liver disorders
•  hormone metabolism
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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
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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
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Normal GI Changes
Functional implications
• No significant functional effects associated with
age
• Common complaints:
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fullness
dysphagia
heartburn
vomiting
sternal pain (differentiate from CV problem)
decreased appetite
constipation
fecal incontinence
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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