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Effects of Aging on the Digestive System

by Atenodoro R. Ruiz, Jr., MD

Because the digestive system has a lot of reserve built into it, aging has less effect on its function than it does on the function of other organ systems. Nonetheless, aging is a factor in several digestive system disorders. In particular, older adults are more likely to develop diverticulosis (see Diverticulosis) and to have digestive tract disorders (for example, constipation—see Large intestine and rectum) as a side effect of taking certain drugs.


With age, the strength of esophageal contractions and the tension in the upper esophageal sphincter decrease (called presbyesophagus—see Overview of the Esophagus), but the movement of food is not impaired by these changes (see Spotlight on Aging). However, many older adults are likely to be affected by diseases that interfere with esophageal contractions.


With age, the stomach lining's capacity to resist damage decreases, which in turn may increase the risk of peptic ulcer disease (see Peptic Ulcer), especially in people who use aspirin and other nonsteroidal anti-inflammatory drugs (NSAIDs). Also with age, the stomach cannot accommodate as much food (because of decreased elasticity), and the rate at which the stomach empties food into the small intestine decreases. However, these changes typically do not cause any noticeable symptoms. Aging has little effect on the secretion of stomach juices such as acid and pepsin, but conditions that decrease acid secretion, such as atrophic gastritis (see Causes), become more common.

Small intestine

Aging has only minor effects on the structure of the small intestine, so movement of contents through the small intestine and absorption of most nutrients do not change much. However, lactase levels decrease, leading to intolerance of dairy products by many older adults (lactose intolerance—see Lactose Intolerance). Excessive growth of certain bacteria (bacterial overgrowth syndrome—see Bacterial Overgrowth Syndrome) becomes more common with age and can lead to pain, bloating, and weight loss. Bacterial overgrowth may also lead to decreased absorption of certain nutrients, such as vitamin B 12 , iron, and calcium.

Pancreas, liver, and gallbladder

With age, the pancreas decreases in overall weight, and some tissue is replaced by scarring (fibrosis). However, these changes do not decrease the ability of the pancreas to produce digestive enzymes and sodium bicarbonate. As the liver and gallbladder age, a number of structural and microscopic changes occur (see Effects of Aging on the Liver).

Large intestine and rectum

The large intestine does not undergo much change with age. The rectum does enlarge somewhat. Constipation becomes more common (see Constipation), which is caused by many factors:

  • A slight slowing in the movement of contents through the large intestine

  • A modest decrease in the contractions of the rectum when filled with stool

  • More frequent use of drugs that can cause constipation

  • Often less exercise or physical activity

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