Fortunately, this is not something we have to live with, medical experts say. "While some systems in the body slow down, an increase in GI problems is not necessarily a normal part of aging," says David L. Carr-Locke, chief of digestive diseases at Beth Israel Medical Center in New York. It's just that many diseases that do affect the gastrointestinal tract develop or become more common as we age, including diabetes, arthritis, high blood pressure, thyroid disease and neurological problems such as Parkinson's disease.
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"The medications we need to treat them also take a toll," says gastroenterologist Brijen J. Shah, assistant professor of gastroenterology, geriatrics and palliative medicine at the Mount Sinai Hospital. Antidepressants, pain relievers, drugs for insomnia, high blood pressure, incontinence, asthma and allergies, and even calcium and iron supplements can trigger or aggravate digestive problems. We also tend to be less active as we age, and exercise is essential for keeping the gut — and the rest of us — healthy.
Thanks to new treatments and smart lifestyle choices, there's a lot you can do to keep everything moving. Here's what you need to know:
What it feels like: Heartburn, a burning, stinging sensation rising from your stomach and chest to your throat; a sour taste in your mouth or constant need to clear your throat; episodes of coughing. If these symptoms happen frequently, you may have gastro-esophageal reflux disease (GERD).
What causes it: The valve between the esophagus and the stomach doesn't work properly, allowing stomach acid to leak upward. Severe cases can damage the lining of the esophagus, putting you at risk for esophageal cancer.
The fix: Change what you eat and when you eat. Although "everyone is different" in what triggers reflux, says Carr-Locke, it's been well established that coffee, tea, chocolate, carbonated drinks, spicy foods, alcohol, dairy products and tomatoes provoke or worsen reflux, and it makes sense to avoid the worst offenders. Keep a food diary so you know what you ate before a flare-up, delete those foods from your diet for two weeks, then gradually add them back to see how your react. Meanwhile, if you smoke, stop. Eat smaller meals, and never eat within two hours of lying down. Prop the head of your bed up by 6 to 10 inches (use blocks or books under the mattress, or buy a wedge-shaped foam pillow).
For short-term relief, try antacids or histamine-2 blockers such as Zantac or Pepcid AC that block stomach acid. More severe cases may require proton pump inhibitors (PPIs) such as Nexium, Prilosec and Prevacid — some of which can be found over the counter, others only by prescription. "Current PPI therapy — which reduces stomach acid — is the best we've ever had," says Carr-Locke. "Many patients find they can tolerate foods they never could before." Note, however, that these medications can have serious side effects and that some experts think they are overused. If symptoms persist after two weeks, or if you vomit blood or have trouble or pain when swallowing, see your doctor.
Next page: Diverticulosis, indigestion and constipation. »