WHAT CHANGES AS YOU AGE

Have you noticed that foods you once enjoyed now leave you feeling bloated? Perhaps you get heartburn more often, or your bathroom routine isn’t quite as predictable as it used to be.

You might shrug your shoulders and say, “Well, I guess that’s what happens when you get old.”

Not so fast!

Your digestive system does change as you age. But here’s something I want you to remember: Getting older does not mean you have to accept constipation, heartburn, bloating, or stomach pain as your new normal.

Many digestive problems have identifiable causes, and many can be improved or treated.

Today, we’re going to take a little trip through your digestive system. Don’t worry. No hospital gown required.

First, let’s understand how digestion works

Think of your digestive system as a long food-processing factory. Its job is to break down food, absorb the nutrients your body needs, and get rid of what’s left.

Here’s how it works.

1. Your mouth and esophagus

Digestion begins when you chew. Saliva moistens your food and starts breaking down starches. Swallowing sends food down your esophagus, the muscular tube connecting your mouth to your stomach.

2. Your stomach

Your stomach mixes food with acid and digestive enzymes. It breaks food into smaller pieces before gradually releasing it into your small intestine.

3. Your small intestine

This is where most digestion and nutrient absorption occur. Your pancreas supplies digestive enzymes, while bile made by your liver helps digest fats.

4. Your large intestine

Your colon absorbs water and turns leftover material into stool. Trillions of microorganisms living in your intestines also help process certain foods.

5. Your rectum

Finally, your rectum stores stool until you’re ready for a bowel movement.

The entire process depends on coordinated muscle contractions, nerves, hormones, and digestive juices.

And like many other body systems, some parts may work differently as we age.

1. Your digestive system may slow down

Your digestive tract moves food along through coordinated muscle contractions called peristalsis.

Imagine squeezing toothpaste through a tube. Your digestive muscles perform a similar job, gently pushing food and waste forward.

As we age, movement through the colon may slow somewhat. The muscles and nerves that help us pass stool may also become less effective.

However, these changes are usually modest. The digestive system generally maintains much of its ability to work normally, even in advanced age.

Slower movement can contribute to constipation because stool spends more time in the colon, where additional water is absorbed.

The result? Harder, drier stool that’s more difficult to pass.

But aging alone is rarely the whole story.

2. Constipation becomes more common

Here’s a number that might surprise you.

Approximately one-third of adults age 60 and older experience constipation, compared with about one-sixth of adults overall.

Constipation doesn’t necessarily mean you aren’t having a bowel movement every day.

Some people normally go three times a day. Others go three times a week.

What matters is your usual pattern and whether you’re experiencing symptoms such as hard stools, straining, or difficulty emptying your bowels.

Several things can contribute to constipation as we age:

• Eating less fiber.
• Drinking too little fluid.
• Becoming less physically active.
• Taking certain medications.
• Having medical conditions such as diabetes or an underactive thyroid.

Sometimes the problem isn’t slow movement through the colon. The muscles that help you have a bowel movement may not be working together properly.

That’s important because different causes require different treatments.

Dr. Mike’s Take

Constipation is common, but it isn’t something you simply have to live with. Finding the cause is often the first step toward finding relief.

3. Your medications may be part of the problem

This is one of the first things I would look at when an older patient complained about new digestive problems.

Many adults over 50 take several medications. Some can affect digestion.

Common examples include:

• Opioid pain medications, which slow bowel movements.
• Iron and calcium supplements, which may cause constipation.
• Certain antidepressants and bladder medications, which can slow intestinal movement.
• Some blood pressure medications, particularly calcium channel blockers.

Even over-the-counter medicines and supplements can contribute.

Never stop a prescribed medication on your own. Ask your doctor or pharmacist to review your medication list if digestive problems develop.

Sometimes adjusting the dose, changing medications, or adding an appropriate treatment can make a substantial difference.

4. Your body may handle certain foods differently

Have you ever enjoyed a big bowl of ice cream only to regret it an hour later? Your ability to digest lactose, the sugar found in milk, may decrease with age. That’s because some people produce less lactase, the enzyme needed to break down lactose. The result can be gas, bloating, abdominal discomfort, and diarrhea.

But don’t automatically eliminate dairy or entire food groups.

Your symptoms might have another cause, and unnecessarily restricting foods can make it harder to get adequate nutrition.

The small intestine usually continues absorbing most nutrients quite well with age. However, certain diseases, medications, and bacterial overgrowth can interfere with absorption.

Persistent diarrhea, unexplained weight loss, or signs of poor nutrition deserve medical attention.

5. Your gut bacteria may change

Your intestines contain trillions of microorganisms. Together, they form what we call the gut microbiome. These tiny residents help process certain foods and interact with your immune system.

The makeup of the microbiome can change as we age, but diet, medications, illness, and lifestyle also influence it. Researchers are studying how these changes affect digestive health and healthy aging. We still have much to learn.

You don’t need an expensive supplement to start supporting your gut. A varied diet containing fiber-rich foods is a sensible place to begin. We’ll explore the microbiome in greater detail later this week.

6. Don’t blame every digestive symptom on aging

This may be the most important part of today’s article. New or persistent digestive symptoms should never automatically be dismissed as getting older. Heartburn, abdominal pain, constipation, and diarrhea can have many causes. Some are relatively simple to treat. Others require medical evaluation.

Digestive warning signs you shouldn’t ignore

Contact your doctor if you experience:

• A persistent change in bowel habits.
• Difficulty swallowing or food getting stuck.
• Unexplained weight loss.
• Ongoing abdominal pain or frequent vomiting.
• Persistent heartburn or diarrhea.

Seek urgent medical care for severe abdominal pain, vomiting blood, black tarry stools, significant rectal bleeding, or abdominal swelling with an inability to pass gas or stool.

Persistent symptoms and constipation warning signs warrant evaluation.

Remember, colorectal cancer and other serious conditions can sometimes cause changes in bowel habits.

Don’t assume that a new problem is simply another birthday present.

7. Five ways to keep your digestive system healthy

The encouraging news is that many digestive problems respond to simple changes.

Eat more fiber. Include fruits, vegetables, beans, and whole grains. Increase fiber gradually to reduce gas and bloating.

Stay hydrated. Adequate fluids help keep stool soft. Follow your doctor’s advice if you have a fluid restriction.

Move your body. Regular walking and other physical activity can help relieve constipation.

Develop a bathroom routine. Try sitting on the toilet after breakfast. Eating naturally stimulates movement in the colon.

Review your medications. Ask whether any prescription drugs or supplements might be contributing to your symptoms.

These measures can help prevent or relieve many cases of constipation.

The Bottom Line

Your digestive system may change with age, but it doesn’t simply wear out.

Constipation, bloating, and other digestive problems often have causes that can be identified and treated.

Pay attention to changes, maintain healthy habits, and don’t ignore persistent symptoms.

Your digestive system has been working hard for you for decades. Give it a little help, and it may continue serving you well for many years to come.

Keep moving, keep learning, and stay healthy!

— Dr. Mike