Oral Cavity and Alimentary Tract

The digestive tract is subject to functional changes with aging. Beginning in the oral cavity, loosening and loss of teeth is a frequent companion of aging. Saliva secretion decreases leading to relative degrees of xerostomia or dry mouth.

Reduced parietal cell function develops in older persons, but prior Helicobacter pylori infections are now thought to be a major cause of hypochlorhydria in later life. An important nutritional consequence of reduced gastric acid secretion is a lesser biological availability of iron. Since iron stores are generally replete in both men and women in later life, this has little practical nutritional impact. The reduced secretion of gastric intrinsic factor, however, contributes to vitamin B12 deficiency, which is an important nutritional problem of older persons.

The capacity of the liver for biliary secretion and the pancreas for digestive enzyme and bicarbonate secretion begins adult life with a >90% excess of the necessary minimum. Secretory function declines with increasing age, but rarely falls below the minimal reserve capacity. The metabolic and detoxifying capacity of the human liver also has a reserve capacity and is not usually compromised by normal aging.

Intestinal motility is reduced with aging as a result of functional changes in the visceral nerves. With decreased transit the residence time of the chyme on the absorptive surfaces is longer, compensating for any senescence in the mucosal uptake itself. The reduction in motility produces the most noticeable and notorious of the manifestations of intestinal health in older persons, namely reduced frequency of defecations.

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