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New Tummy Troubles? How Aging Affects the Digestive System

Learn how these changes can impact your health at 50-plus — and what you can do to get some relief


digital illustration of digestive system
Shana Novak (Prop Stylist: Michelle Longo/Halley Resources)

Your digestive system is hard at work 24/7. With breakfast, lunch, dinner and snacks in between, breaking down food into nutrients for use as energy, growth and cell repair is an exhausting schedule.

After decades of this routine, your digestive system would probably like to retire. While that’s not an option, it does slow down as you get older, which can give rise to new health challenges.

Here’s a look at what happens to your digestive system as you age and how you can alleviate some common complications.

Digestive changes — from gum to bum

Digestion starts in your mouth, says Sarah Cook, a registered dietitian at UR Endocrinology at Highland Hospital in Rochester, New York. Many older adults have xerostomia, “a fancy way of saying lack of saliva or dry mouth,” Cook explains, making it difficult to taste and swallow food.

This is often a side effect of medications like muscle relaxers and those taken for allergies, depression and Parkinson’s disease. Cook points out that our teeth age, too, and those changes can also interfere with chewing, swallowing and digesting.

From your mouth, your chewed food — now a small ball called a bolus — enters your esophagus, which starts pushing it toward your stomach. However, aging muscles are not as strong as they once were, and a decrease in muscle contractions makes it harder for food to move through the digestive tract, slowing digestion and creating a feeling of fullness.

“Often [older adults] don’t feel hunger, and they have a decreased appetite, which can lead to all kinds of problems,” such as not getting enough calories or making poor nutritional choices and “eating things that are more pleasurable versus more nutrient-dense,” says Sandra Darling, an osteopathic physician in the Department of Wellness and Preventive Medicine at the Cleveland Clinic.

Along the way, digestive enzymes in your mouth, pancreas, stomach and small intestines help break down your food. But as we age, there’s a decline in the production of these enzymes, making it more difficult to break down food into smaller particles that can be absorbed into the body.

“That can lead to abdominal pain and food sensitivities that were never a problem before,” such as an intolerance to lactose or dairy products, Darling says. It also can increase sensitivity to acidic, spicy or greasy foods. “Foods that maybe you could eat when you were middle-aged, all of a sudden are very difficult [to consume],” Darling adds. “And it can cause a lot of pain; it can cause a lot of acid reflux.”

Common digestive issues for older adults

While gastrointestinal (GI) problems can plague anyone at any age, older adults tend to experience them more often, which doesn’t always bode well for overall health.

“They say our health begins in our gut, and as soon as you have an unhealthy digestive system, that can lead to an unhealthy body and brain,” Darling says.

According to the Cleveland Clinic, some common GI issues that may worsen with age include:

  • Constipation. You feel full and have difficulty passing stool, which may be hard or dry. Not eating enough fiber and not drinking enough water can cause this uncomfortable condition, and so can some medications. About one-third of older adults have occasional symptoms of constipation, the National Institute on Aging says.
  • Gastroesophageal reflux disease, also known as GERD or acid reflux. You may have a burning sensation in your throat or have trouble swallowing due to stomach acid flowing back up through the esophagus.
  • Diverticulosis. According to the Cleveland Clinic, 50 percent of people over 60 have this ailment, in which small pouches develop on your intestines and push through weak spots in the outer wall. You may feel pain in your lower abdomen or have a fever if there’s an infection (known as diverticulitis). Research suggests that diverticulosis is caused by a diet low in plant fiber and high in processed starches. This may make it difficult to expel waste and put pressure on the colon.
  • Inflammatory bowel disease (IBD), an umbrella term that includes Crohn’s disease and ulcerative colitis. IBD is an autoimmune disorder in which a person’s immune system attacks the GI tract, leading to chronic inflammation. Symptoms can include abdominal pain, weight loss, diarrhea, fatigue, fever and blood in the stool.

According to the Centers for Disease Control and Prevention (CDC), the condition appears to result from interactions between genetics and the environment. A study published in 2021 in the CDC's Morbidity and Mortality Weekly Report found that the prevalence of IBD in older adults has risen over the past two decades.

IBD should not be confused with IBS (irritable bowel syndrome), which can cause cramping, belly pain, bloating, gas, diarrhea and/or constipation. The exact causes of IBS aren’t known, but it can be triggered by stress, food allergies, and severe infection, among other things.

Lifestyle changes can help relieve symptoms

There are a few general steps you can take to alleviate digestive issues. For example, stress can exacerbate GI troubles, so “it’s critical to learn some breathing techniques, meditation, even walking in nature” to help manage stress, Darling says.

In addition to reducing stress, you can do the following to help tackle digestive issues and keep your digestive system running smoothly:

  • Limit triggers like caffeine, spicy foods and citrus
  • Eat smaller meals
  • Eat earlier in the evening to give your body more time to digest before lying down to sleep. (As a side note, depending on what you’ve eaten, it takes two to five days for your food to go all the way through — and out — your digestive system.)
  • Eat fiber-rich foods, like whole grains (barley, brown rice), whole-wheat pasta or bread, fruits, vegetables, beans, and nuts. These foods can help stool pass more easily through your digestive system. The National Academy of Medicine recommends 21 grams of fiber for women over 50 and 30 grams for men over 50.
  • Participate in regular physical activity. “Just more movement in general,” Darling says.
  • Drink lots of water. That said, all fluids count. The National Council on Aging suggests dividing your body weight by three and drinking that number of ounces in fluids. If you’re 150 pounds, that means 50 ounces of water daily. Hydration helps stave off constipation.

There is a bit of a paradox when it comes to digestion, nutrition and aging. As we age, “our nutrient requirements for vitamins and minerals increase, but the recommended calorie intake decreases,” Cook says.

Moderately active females should get 1,800 calories daily, and moderately active males should get 2,200 to 2,400 calories daily, according to the National Institutes of Health. “Try to make every meal or snack count,” Cook says. “Make it a nutrient-dense option and not waste your calories on things that aren’t giving you much other than pure calories.”

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