Review Article

Gastrointestinal Tract Disorders in Older Age

Table 3

Gastric disease characteristics in older adults.

Chronic atrophic gastritis(i) More prevalent in elderly
(ii) Elderly from Japan and China have increased prevalence above 50%
(iii) Changes in human gastric microbiota associated with increased risk for gastric cancer
(iv) Associated with osteoporosis and autoimmune thyroid disease

H.pylori infection(i) Incidence in elderly highest in developed countries
(ii) Type I cancerogen associated with gastric adenocarcinoma
(iii) Extra intestinal manifestation may be more frequent in elderly but association with H.pylori warrants further study

Peptic ulcer disease(i) Mortality higher than in younger groups
(ii) Use of NSAID/aspirin is the main risk
(iii) Age-related physiological changes such as reduced gastric blood flow and decreased production of bicarbonates, mucin prostaglandins contribute to higher prevalence
(iv) Clinical manifestation is usually atypical (only 30% have typical epigastric pain)
(v) Perforation usually lacks typical clinical symptoms of chemical peritonitis
(vi) PPI associated with CDC, CAP and OP

PPI- proton pump inhibitor; CDC- Clostridium difficile colitis; CAP- community acquired pneumonia; OP-osteoporosis.