A friend complains that she's often queasy when she wakes up in the morning.
Another mentions that he cannot eat fast food anymore without regretting it for hours.
I learned what gas and bloating was when I was pregnant with my third child. That child is now 12, and my 50-something body is revisiting this two-pronged annoyance.
Are these changes normal? Do they result from age-related changes? Are they something to be checked out by a doctor?
John Clarke, a gastroenterologist at Johns Hopkins University, says there are changes in the body - from mouth to stomach to bowels - that occur with age that may account for many minor digestive issues.
Before we tour the gastrointestinal tract, let's listen to Colleen Christmas, an expert in geriatric medicine at Hopkins.
Everybody's body slows down, she agrees, but that doesn't necessarily mean it will cause problems. Most times, age-related changes in your gut will go unnoticed.
"The two big exceptions are constipation and diverticulosis," Christmas says. Diverticulosis is a condition, not a disease, she says. "It's little pockets where the intestine has ballooned out. It's pretty uncommon before age 40, but almost all 80-year-olds have it." Not all 80-year-olds are aware of it, though, as it is often a symptomless condition. When problems do occur, people may experience abdominal pain and fever.
An estimated 12 to 19 percent of Americans deal with constipation; that percentage climbs with age, with estimates of 16 to 26 percent in those older than 65 and 26 to 34 percent in those older than 80. The problem is more common in women.
Constipation can result from multiple factors, including a weakening and slowing of the muscles in the small and large intestine, medication side effects and a decrease in physical activity, Christmas says. You can see why this might be a triple whammy in older adults, who tend to take more medicine, exercise less and experience an overall slowdown.
To combat constipation, increase your fluid intake, increase your activity level and add more fiber to your diet. High-fiber foods include fruits, vegetables and whole grains. Prunes are especially good because they also act as a natural laxative, pulling water into the gastrointestinal tract.
The slower transport of intestinal contents also means that partially digested food, including fiber, has more time to ferment. That means more gas and more flatulence, Clarke says. Humph, that's me.
If the extra fiber you take to prevent constipation gives you extra gas, you might avoid other gas-producing culprits, such as beans and cruciferous vegetables such as broccoli.
Do food sensitivities change with age? Christmas says the small intestine makes less of the enzyme that breaks down lactose, so older adults may become more sensitive to dairy products that contain lactose. Clarke says a similar thing can happen with gluten, in that gluten may cause more gas, bloating and discomfort as people age.
"If gas is more common, you might have to be more strict with your diet," Clarke says. For people like me, whose troubles are occasional, he suggests paying attention to which foods may trigger the discomfort and avoid them for a week at a time to see whether that makes a difference.
Moving up the gastrointestinal tract, older stomachs don't expand as well as younger ones, which means you'll feel full sooner. "High-fat foods tend to slow motility in the stomach," Clarke says. I'll share that bit of information with my fast-food-avoiding friend.
And for my friend with morning queasiness? It may well be menopause in addition to the effects of age. The drop in estrogen that occurs in early menopause can further slow the processing of food, says Ellen Dolgen, a menopause expert and author of "Menopause Mondays: The Girlfriend's Guide to Surviving and Thriving During Perimenopause and Menopause." Studies have shown that peri-menopausal women report more digestive issues, including gas and bloating. Humph, that's me, too.
In the mouth, the aged tongue has fewer taste sensors than a young one has, which means, Clarke says, that you can lose your taste for certain foods and have less of an appetite. "Food preferences may change," he says, and varying your diet may help you find new foods to enjoy.
There are over-the-counter remedies for gas, constipation and indigestion. GasX and Phazyme both contain simethicone, which help small gas bubbles coalesce into larger ones that are easier to pass. Laxatives for constipation come in a couple of forms; Mirolax helps water stay in the stool, and Senna is a plant-derived mixture that stimulates fluids and motility in the bowel. Peppermint has long been recognized to help with fullness and indigestion - it's why after-dinner mints are popular. Peppermint helps relax the stomach, allowing it to expand and its owner to feel more comfortable.
Christmas warns that the impulse to take medications, even over-the-counter ones, should be challenged, especially in older people who are already taking various drugs. The better question is, she says, "Is there something you can stop taking?" In her experience, double-checking her patients' current medications usually yields a culprit or two that are causing digestive issues. "Nine times out of 10, it's a side effect of medication," she says.
And not to be alarmist, but Clarke reminds me that cancers do appear more often as we age. "Any [digestive] symptom that's new and you're past 50, you should probably see a gastroenterologist."
(c) 2016, The Washington Post
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