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      Gastrointestinal Tract Disorders in Older Age

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          Abstract

          Considering an increase in the life expectancy leading to a rise in the elderly population, it is important to recognize the changes that occur along the process of aging. Gastrointestinal (GI) changes in the elderly are common, and despite some GI disorders being more prevalent in the elderly, there is no GI disease that is limited to this age group. While some changes associated with aging GI system are physiologic, others are pathological and particularly more prevalent among those above age 65 years. This article reviews the most important GI disorders in the elderly that clinicians encounter on a daily basis. We highlight age-related changes of the oral cavity, esophagus, stomach, small and large bowels, and the clinical implications of these changes. We review epidemiology and pathophysiology of common diseases, especially as they relate to clinical manifestation in elderly. Details regarding management of specific disease are discussed in detail if they significantly differ from the management for younger groups or if they are associated with significant challenges due to side effects or polypharmacy. Cancers of GI tract are not included in the scope of this article.

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          Helicobacter pylori infection.

          Sebastian Suerbaum, Pierre Michetti (2002)
          Article 0 comments Cited 655 times – based on 0 reviews     Review now
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            Clinical Practice Guidelines for Clostridium difficile Infection in Adults and Children: 2017 Update by the Infectious Diseases Society of America (IDSA) and Society for Healthcare Epidemiology of America (SHEA)

            Dale Gerding, Karen C Carroll, Stuart Johnson … (2018)
            A panel of experts was convened by the Infectious Diseases Society of America (IDSA) and Society for Healthcare Epidemiology of America (SHEA) to update the 2010 clinical practice guideline on Clostridium difficile infection (CDI) in adults. The update, which has incorporated recommendations for children (following the adult recommendations for epidemiology, diagnosis, and treatment), includes significant changes in the management of this infection and reflects the evolving controversy over best methods for diagnosis. Clostridium difficile remains the most important cause of healthcare-associated diarrhea and has become the most commonly identified cause of healthcare-associated infection in adults in the United States. Moreover, C. difficile has established itself as an important community pathogen. Although the prevalence of the epidemic and virulent ribotype 027 strain has declined markedly along with overall CDI rates in parts of Europe, it remains one of the most commonly identified strains in the United States where it causes a sizable minority of CDIs, especially healthcare-associated CDIs. This guideline updates recommendations regarding epidemiology, diagnosis, treatment, infection prevention, and environmental management.
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              Ulcerative colitis practice guidelines in adults: American College Of Gastroenterology, Practice Parameters Committee.

              Asher Kornbluth, David Sachar (2010)
              Guidelines for clinical practice are aimed to indicate preferred approaches to medical problems as established by scientifically valid research. Double-blind placebo controlled studies are preferable, but compassionate-use reports and expert review articles are used in a thorough review of the literature conducted through Medline with the National Library of Medicine. When only data that will not withstand objective scrutiny are available, a recommendation is identified as a consensus of experts. Guidelines are applicable to all physicians who address the subject regardless of specialty training or interests and are aimed to indicate the preferable but not necessarily the only acceptable approach to a specific problem. Guidelines are intended to be flexible and must be distinguished from standards of care, which are inflexible and rarely violated. Given the wide range of specifics in any health-care problem, the physician must always choose the course best suited to the individual patient and the variables in existence at the moment of decision. Guidelines are developed under the auspices of the American College of Gastroenterology and its Practice Parameters Committee and approved by the board of trustees. Each has been intensely reviewed and revised by the Committee, other experts in the field, physicians who will use them, and specialists in the science of decision analysis. The recommendations of each guideline are therefore considered valid at the time of composition based on the data available. New developments in medical research and practice pertinent to each guideline will be reviewed at a time established and indicated at publication to assure continued validity. The recommendations made are based on the level of evidence found. Grade A recommendations imply that there is consistent level 1 evidence (randomized controlled trials), grade B indicates that the evidence would be level 2 or 3, which are cohort studies or case-control studies. Grade C recommendations are based on level 4 studies, meaning case series or poor-quality cohort studies, and grade D recommendations are based on level 5 evidence, meaning expert opinion.
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                Author and article information

                Contributors
                Tamara Milovanovic:
                ORCID: http://orcid.org/0000-0002-6608-5233
                Journal
                Journal ID (nlm-ta): Can J Gastroenterol Hepatol
                Journal ID (iso-abbrev): Can J Gastroenterol Hepatol
                Journal ID (publisher-id): CJGH
                Title: Canadian Journal of Gastroenterology & Hepatology
                Publisher: Hindawi
                ISSN (Print): 2291-2789
                ISSN (Electronic): 2291-2797
                Publication date Collection: 2019
                Publication date (Electronic): 17 January 2019
                Volume: 2019
                Electronic Location Identifier: 6757524
                Affiliations
                1Division of Hospital Medicine, Mayo Clinic Health System, Eau Claire, WI, USA
                2Mayo Clinic College of Medicine and Sciences, Rochester, MN, USA
                3Department of Family Medicine, Mayo Clinic Health System, Eau Claire WI, USA
                4Gastroenterology Fellowship Program, The Wright Center for Graduate Medical Education, Scranton, PA, USA
                5Clinic for Gastroenterology and Hepatology, Clinical Center of Serbia, Belgrade, Serbia
                6School of Medicine, Belgrade University, Belgrade, Serbia
                Author notes

                Academic Editor: Robert Flisiak

                Author information
                http://orcid.org/0000-0002-5312-8812
                http://orcid.org/0000-0003-4836-4439
                http://orcid.org/0000-0002-6608-5233
                Article
                DOI: 10.1155/2019/6757524
                PMC ID: 6354172
                PubMed ID: 30792972
                SO-VID: ebe785c0-6e39-4ce4-b2b7-95e1e15338b9
                Copyright © Copyright © 2019 Igor Dumic et al.
                License:

                This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                Date received : 30 April 2018
                Date revision received : 11 December 2018
                Date accepted : 17 December 2018
                Categories
                Subject: Review Article

                Data availability:

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