Research Makes Gastrointestinal Health A Senior Care Priority (Part 2 of 2)

Gastrointestinal Problems

The NCI identifies the most common gastrointestinal problems examined by gastrointestinal specialists or gastroenterologists as constipation, impaction, bowel obstruction, diarrhea, radiation enteritis, gastrointestinal perforation, anthrax, gastroenteritis/colitis, laxative overdose, angiodysplasia of the colon and gastrointestinal bleeding.

Constipation

Constipation is the slow, uncomfortable and possibly painful movement of dry, hard stool through the large intestine. This condition worsens as more fluid is absorbed and the waste becomes drier and harder.

If waste matter is not removed from the intestine at least once a day to three per day and at least three per week, physicians may diagnose a senior patient with constipation.

A physician assesses for constipation by reviewing the history of a patient’s bowel habits, including distention, gas passage, cramping and rectal fullness, a change in diet and drug use and by conducting occult blood tests and regular physical exams.

A lack of physical activity, a form of disability or social barriers such as the lack of bathroom accessibility, can cause constipation. So, too, can depression and anxiety brought on by cancer treatment or pain, insufficient water or fluid intake and the ingredients of certain pain relievers, though these last two factors can be managed.

To manage constipation, doctors may suggest that patients increase their intake of fiber through fruits, vegetables, whole-grain cereals, breads and bran and water or other fluids.

In fact, research was conducted involving senior patients, including cancer patients, to compare the medical care effectiveness, cost and management of a natural laxative mix of raisins, currants, prunes, figs, dates and prune versus the use of stool softeners, lactulose and other laxatives. The results found the natural laxative mix to be more medically and cost efficient.

Impaction

By contrast, while constipation is uncomfortable and painful, fecal impaction is dangerous. Impaction is the collection of dry, hard waste matter in the rectum or colon.

Most senior patients with impaction may exhibit circulatory, cardiovascular or respiratory problems more than gastrointestinal issues but the main symptoms are back pain and bladder, urethra and urinary problems, especially frequent urination.

Physicians assess for impaction by asking the patient questions about constipation, using instruments to listen for bowel sounds, examining the abdomen to determine the level of gastrointestinal activity and conducting a rectal exam for the presence of stool in the rectum or colon and an abdominal X-ray for such features as gas passage.

Stool movement around impaction may produce diarrhea and coughing. It may also lead to stool leakage, which comes with nausea, vomiting, abdominal pain and dehydration.

Such a patient may be found in a confused or disoriented state and suffering from fever and high or low blood pressure. If not detected and addressed immediately, impaction may result in death.

The main causes of impaction are opioid medication, a lack of physical exercise or activity, changes in diet, psychiatric illness or abuse of laxatives. In fact, laxative abuse aimed at decreasing constipation is considered the major cause of impaction. Overuse of laxatives makes the colon insensitive to natural reflexes caused by distention.

Doctors treat impaction by watering and softening the stool for removal. They use enemas that incorporate oil retention, tap water or hypertonic phosphates to moisten the bowel and remove the stool. Often, docusate, mineral or olive oil and glycerin suppositories are used.

Occasionally, after an enema is used, a patient may be disimpacted digitally to address the remaining waste matter.

Bowel Obstruction

Large or small bowel obstruction is a partial or complete blockage of the bowel by a method other than constipation and impaction. Eighty percent of bowel obstructions take place in the small intestine while the other 20 percent happens in the colon. A physician may make a determination of obstruction if there is no gas.

An obstruction is classified by three ways: the type of obstruction, the mechanism of obstruction (whether mechanical or nonmechanical) and the part of the bowel in question. Often, it is termed “twisted bowel.”

Total or partial obstruction is typically caused by structural disorders like bowel lesions connected to cancer, post-surgical abdominal problems or hernias. Additionally, a patient with a colostomy, a type of surgery that re-directs a part of the colon to avoid a damaged part of the gastrointestinal tract, are at risk of developing constipation.

There are four types of obstruction: simple in which one site is blocked; closed-loop with blockage in two places; strangulated involving decreasing blood flow, and; incarcerated when the strangulated state is not resolved.

To determine bowel obstruction, physicians may examine a patient for abdominal pain, vomiting and gas or stool passage and may conduct a white blood cell count, electrolyte panel, urinalysis, sepsis, flat or upright abdominal films, enemas and gastrointestinal series.

To treat and manage obstruction, doctors may perform volume resuscitation, elecrolyte imbalances, transfusion support, distended bowel decompression efforts via intestinal tubes, a change in diet and the use of stents.

Diarrhea

As diagnosed, diarrhea is an unhealthy increase in stool liquid and frequency of passage of more than three instances of waste matter from the intestine in a 24-hour period. It can span more than four days but less than two weeks. While considered less prevalent than constipation, diarrhea is considered chronic if it lasts more than two months.

Increasingly, the process of cancer care, especially radiation therapy and the stress and anxiety caused, antibiotic therapy, bone marrow transplants or gastrointestinal surgery, are among the main causes of diarrhea and the results can be physically and emotionally damaging.

Diarrhea can change a senior patient’s diet, prompt dehydration, cause electrolyte imbalance, stop function, induce fatigue, affect skin health, restrict physical activity and can be dangerous.

To manage diarrhea, physicians may treat such conditions as impaction; change the laxative therapy in use and the diet of the patient in question for low-fiber, mineral-rich foods that don’t upset the digestive tract; introduce opioid and aspirin use, and; increase liquid intake of water, broths, weak teas, caffeine-free soft drinks, clear juices and gelatin.

Radiation Enteritis

Radiation enteritis is a disorder of the large and small bowels that occurs during and after a session of radiation therapy to the abdomen, pelvis or rectum. The large and small bowels are vulnerable to radiation meant to treat cancer. While radiation dosages can effectively control cancerous tumors, normal tissues can be damaged in the process.

To assess radiation enteritis, physicians may seek out acute signs of injury to the digestive tract after the first session of radiation therapy and up to eight weeks later though some symptoms may present after many months or years. The signs include nausea, vomiting, abdominal cramping and pain, weight loss, and watery diarrhea.

The incidence of radiation enteritis may involve the following factors: dosage of therapy; tumor size and extent; the volume of the bowel treated; other symptoms and illnesses experienced by the patient; the malfunction of the digestive tract in terms of the absorption of fat, lactose, bile salts and vitamin B12; the level of pain felt by the patient; the nature of accompanying discharge, and; the presence of blood in the tract.

To manage enteritis, doctors will consider the level of diarrhea, dehydration, lack of absorption of nutrients and pain and discomfort experienced; attempt to address these with medicine such as brand-name Kaopectate and Immodium liquid formulas, opioids, steroid foams and replacement enzymes; changes in diet, including the use of lactase, fish, poultry and meat, fruit, white bread and toast, pasta, potatoes, vegetables and dairy products; bowel surgery, and; physical rest.

Gastrointestinal Perforation

Gastrointestinal perforations are holes in the wall of the stomach, small intestine, large bowel or gall bladder and a matter of medical emergency. Perforations are generally caused by illnesses such as appendicitis, diverticulitis, ulcer disease, gallstones or gallbladder infection and inflammatory bowel disease, including Crohn’s disease and ulcerative colitis. They lead to leakage of intestinal substances into the abdomen, leading to a form of inflammation called peritonitis.

Anthrax

Anthrax, an infectious disease caused by the bacteria called bacillus anthracis, involves the skin, the gastrointestinal tract or the lungs. This illness, which affects hoofed animals such as sheep and goats, inflicts humans who come into contact with them.
Typically, farm workers, veterinarians and tannery and wool workers tend to be patients. They may contract cutaneous anthrax through a cut or scrape on the skin, inhalation anthrax through the lungs with anthrax spores and gastrointestinal anthrax through anthrax-tainted meat.

Gastroenteritis/Colitis

Gastroenteritis/colitis, an inflammation of the stomach or intestine due to infection by the virus cytomegalovirus (CMV), is caused by a herpes-type virus related to one that leads to the onset of chickenpox.

Throughout their lives, most people confront the virus by saliva, urine, respiratory droplets, sexual contact and blood transfusions. It creates mild or no symptoms in healthy individuals.

However, some individuals with weak immune systems can develop CMV infections, including patients receiving chemotherapy for cancer, treatment for AIDS and immune-suppressing drugs after an bone marrow or organ transplant.

Those with strong immune systems may acquire CMV infections from a physical injury, kidney failure or infection.

Laxative Overdose

Laxative overdose can take place when an individual accidentally or intentionally ingests more than the normal or recommended amount of drugs. Some overdoses in children are by accident but adults primarily abuse laxatives to lose weight.

The toxic ingredients in the most abused laxatives are bisacodyl (Dulcolax), carboxymethylcellulose, castor oil, docusate, glycerin, lactulose, magnesium citrate, magnesium hydroxide, magnesium oxide, magnesium sulfate, malt soup extract, methylcellulose, milk of magnesia, mineral oil, potassium bitartrate and sodium bicarbonate, psyllium, psyllium hydrophilic mucilloid, senna and sodium phosphate.

Angiodysplasia of the Colon

Angiodysplasia of the colon, which involves enlarged and fragile blood vessels in the colon that result in bleeding in the gastrointestinal tract, primarily affects senior patients. It relates to the aging and degeneration of the blood vessels.

Research is still determining the cause of this illness. The greatest cause are normal spasms of the colon that enlarge blood vessels in the gastrointestinal tract.

With severe swelling, a small route develops between a very small artery and vein, which is called an arteriovenous fistula. It is in that portion of the colon wall that a senior patient may experience bleeding.

Angiodysplasia of the colon is not connected to the diseases of the blood vessels, cancer and diverticulosis, another condition of intestinal bleeding in senior patients.

Gastrointestinal Bleeding

Gastrointestinal bleeding refers to bleeding that starts in the upper part of the small intestine to include the small and large bowels in the digestive tract, which starts from the mouth and ends with the anus.

The extent of bleeding ranges from miniscule that can only be detected by laboratory testing to massive and it may indicate serious illness. Long-term microscopic bleeding can mean anemia. Severe massive bleeding can result in hypovolemia, shock and death.

The bleeding can take place at any age from the time of birth onward. The level and location of bleeding dictates what type of tests will be conducted to find the cause. Once bleeding is detected, a number of treatments are available to stem it.

Causes of gastrointestinal bleeding include anal fissure, aorto-enteric fistula, arterio-venous growth, diverticulum, cancer of the small intestine, colon cancer, cow’s milk allergy, Crohn’s disease, duodenal ulcer, dysentery, esophagitis, gastric ulcer, hemorrhoids, intestinal polyps, intestinal obstruction, intestinal vasculitis, nosebleed, portal hypertensive gastropathy, radiation injury to the bowel, stomach cancer and ulcerative colitis.

Foodborne Illnesses

With age, the immune system gradually ceases to function, leading to a decrease in the level of disease-fighting cells and an increased risk of infections. Exacerbating this is the frequency of surgeries by senior patients, which further compromises the body’s ability to ward off infections.

This makes it easier for foodborne illnesses to take hold, James L. Smith, a microbiologist with the U.S. Department of Agriculture concluded in his research.

Smith arrived at this finding after reviewing data from foodborne illnesses at nursing homes, conducting regular physical exams, studying the immune and digestive systems of seniors and looking at the importance of long-term exercise in strengthening the immune system.

Additionally, with aging, inflammation of the lining of the stomach and a drop in stomach acid takes place. The stomach is instrumental in restricting the amount of bacteria in the small intestine so that a decrease in stomach acids raises the danger of infection if it is digested with food or liquid.

Worsening this condition is the deceleration of the digestive process, enabling the spread of bacteria, fungi and viruses in the gut and the development of poison.

Malnutrition is connected to foodborne illness in that it leads to more infections and takes place with seniors in part because of a decrease in the pleasure of eating, the use of various medicines, digestive illnesses, nondigestive diseases, physical disabilities or depression, all of which may lead to a loss of appetite. Sound nutrition is key to keeping a healthy immune system.

Symptoms of foodborne illness include diarrhea, abdominal cramping, fever, blood or pus in the stools, headache, vomiting and severe exhaustion. This depends on the type of bacteria involved and the sum of toxins digested.

The symptoms can present themselves a half-hour after eating or may not arrive for days or weeks. They may start in a day or two but can stay as long as a week to 10 days. In healthy individuals, foodborne illnesses don’t last long and are not dangerous but they can be both lengthy and lethal in seniors.

In the case of foodborne illness, senior patients or their families must act immediately, Smith says in his research. Seniors must store and mark a portion of the suspect food, recording the food type, the date, the time consumed and the moment the symptoms began.

They must obtain treatment, call their local jurisdictional health department if they digested the food at a large event, from a restaurant or food facility and contact the Food and Drug Administration’s (FDA) consumer food information line if they have questions, he says.

Senior patients must also avoid food poisoning in the future by removing uncooked foods from their diets. Their physicians advise them to steer clear of raw fin fish and shellfish, including oysters, clams, mussels and scallops; unpasteurized or untreated milk or cheese or fruit or vegetable juices; soft cheese such as feta, Brie, Camembert, blue-veined and Mexican-style cheese; raw or uncooked egg or egg products such as salad dressings, cookie or cake batter, sauces and egg nog; raw meat or poultry, and; or raw alfalfa sprouts.

Most fruit or vegetable juices in the nation — amounting to 98 percent — have been treated to eliminate bacteria. The FDA requires companies to place warnings on their products.

Natural Foods, Herbal Remedies for Gastrointestinal Health

Aside from the aforementioned treatments and modes of management for gastrointestinal illnesses as constipation, impaction, bowel obstruction, diarrhea, radiation enteritis, gastrointestinal perforation, anthrax, gastroenteritis/colitis, laxative overdose, angiodysplasia of the colon and gastrointestinal bleeding, a variety of natural foods and herbal remedies exist to treat these conditions.

To respond to these diseases, physicians also recommend the use of chamomile tea, green tea, high-fiber flaxseeds, oats, omega-3s, flax oil, ginger, milk thistle, psyllium, saw palmetto, high-fiber hot peppers, onions, sweet red bell peppers, rice, barley, cabbage, beets, carrots, Brussels sprouts, cauliflower and water.

Chamomile tea has and still remains a remedy for relaxation, to cure insomnia and to soothe an aching stomach. Being researched for its antioxidant, antispasmodic and antiseptic properties, it has been used to treat skin irritation, intestinal cramps and wracked nerves. In tea form, chamomile is drunk three to four times daily to eliminate gastrointestinal upset.

Flaxseeds contain protein, dietary fiber and omega-3 fats and can be found in breads and cereals. Flaxseed oil is a rich source of lignans, a plant compound with hormone-like effects on the body, and omega-3 alpha-linolenic acid, a fatty acid that makes up 55 percent of its oil and is anti-inflammatory and boosts the immune system.

Omega-3s and lignans cut back on the risk of certain types of cancer such as breast, colon, prostate and uterus. Physicians recommend grinding the flaxseeds into a coffee grinder before placing them on bread, pancakes or muffin batters. The flax oil also are used as a supplement and can be placed in salads.

Ginger has long been used as a digestive aid as it enables the secretion of digestive juices in the stomach. Research also finds that ginger is effective in treating nausea, especially from motion or sea sickness and from surgery.

The most natural means of using ginger is to make infusions from grated or sliced ginger root though dosage isn’t calculated. For powdered root, the dosage of ginger is 150 milligrams to 1 gram in capsule several times a day.

It can also be obtained as candied or crystallized ginger at gourmet or Asian markets. A one-inch square is equal to one 500-mg capsule.

However, ginger is not recommended for individuals enduring chemotherapy if their blood cell count is low as it functions as a blood thinner and could place a senior patient at risk for internal bleeding.

Green tea is also useful as an herb to hydrate patients and contains antioxidants that defend against bacteria, which is important as dehydration can lead to constipation. Aside from teas, senior patients are also urged to drink plenty of fluids, particularly water.

Milk thistle, because of its active ingredient silymarin, can guard liver cells against poisons, including medications, viruses and radiation. In fact, it fights inflammation and disease caused by alcoholism, toxins and poisonous mushrooms and can help a liver reconstruct with no side effects.

Diabetics are asked to speak with their physicians about watching their blood sugar while taking milk thistle. A normal dosage amounts to 140 milligrams in a capsule two to three times per day.

Psyllium contains soluble fiber through the dried husks of its seeds. It lowers blood cholesterol and functions as a laxative on an over-the-counter basis. It is also present in some cereals. The FDA approved health claims on cereals containing psyllium.

The agency mandates that each product contain at least 1.7 grams of fiber per serving. Senior patients must drink plenty of water and other drinks when eating psyllium-rich cereals or it can lead to gastrointestinal blockage.

Saw palmetto serves as an inflammatory agent but it also offers relief to men suffering from benign prostatic hyperplasia, or BPH, or the slow but gradual growth of the prostate gland. Daily dosing amounts to 160 milligrams twice. The herb also works well with others such as nettle root and pumpkin seed extract without serious side effects.

Some processed medicines used by senior patients can be used with herbs. Some blood thinners and anti-clotting agents can work with Asian ginseng, dong quai, ginkgo, ginger, feverfew and garlic. However, heart drugs like digoxin produce negative interactions when mixed with Asian ginseng or St. John’s wort.

As a result, senior patients must follow instructions when dosing herbals. Researchers ask seniors over the age of 70 to take about 80 percent of the recommended adult dosage of any herbal preparation. Seniors who are frail or cannot take some drugs should begin with half the recommended dosage of medicines.

Some foods have been billed as colon cleaners when eaten raw. These include hot peppers, onions and sweet peppers. Oats join flaxseeds as being highest in soluble and insoluble fiber. Other foods that also known to cleanse the digestive tract include barley, beets, Brussels, cabbage, carrots, cauliflower and watermelon.

RESOURCES:

Altshuler, Larry, M.D., and Connors, Martha Schindler, “Seniors and Health,” Gastrointestinal Health Program, http://www.sentara.com/HospitalsFacilities/Hospitals/Bayside/Pages/bayside-programs-serivces.aspx

American Accreditation Healthcare Commission, http://www.urac.org.

American College of Gastroenterology, http://www.acg.gi.org.

American Gastroenterology Association, http://www.gastro.org.

Gastrointestinal Bleeding, http://www.healthcentral.com/ency/408/003133trt.html

“Gastrointestinal Complications: Supportive Care – Health Professional Information,” National Cancer Institute, http://cancer.gov

“Gastrointestinal Health in Seniors,” http://health.howstuffworks.com/herbal-remedies.htm

International Foundation for Functional Gastrointestinal Disorders (IFFGD), http://www.iffgd.org

“Keys To Gastrointestinal Health,” http://www.helium.com/knowledge/10322-keys-to-gastrointestinal-health

Liver Foundation, http://www.liverfoundation.org

National Digestive Diseases Information Clearinghouse, http://digestive.niddk.nih.gov

Research Makes Gastrointestinal Health A Senior Care Priority (Part 1 of 2)

Research on newer long-term illness issues, personal habits and socioeconomic trends are prompting senior care facilities to make gastrointestinal health one of its top medical concerns, healthcare providers, federal biological science investigators and medical policymakers say.

Documented key trends factoring into the decisions of senior long-term care and short-term care facilities to prioritize gastrointestinal health include the aging of the Baby Boomers, past and present drug abuse, alcoholism and cigarette smoking, the onset of cancer and other deadly diseases, environmental pollution, the use of bottled water, poor eating, sleeping and exercise habits and a struggling economy.

All impact the health of the digestive tract, research reveals, as aging in general without intervention from a proper diet, obtaining enough sleep and practicing physical exercise places gastrointestinal health in decline.

Namely, abuse of certain categories of drugs such as heroin cause constipation. Alcoholism undermines the function of the liver. Smoking, environmental pollution and sometimes contaminated bottled water can lead to heartburn, gastroesophageal reflux disease (GERD), peptic ulcers, liver disease, Crohn’s disease, colon polyps, pancreatitis and gallstones.

Radiation and other therapies to treat cancer causes gastrointestinal problems. An economic crisis is likely to negatively affect an individual’s eating, sleeping and exercise routines and, thus, affect gastrointestinal health, which is dependent on them.

Research by federal agencies such as the National Cancer Institute (NCI), the National Institute of Diabetes, Digestive and Kidney Diseases (NIDDK), the Food and Drug Administration (FDA) and professional trade associations such as the Liver Foundation, the American Accreditation Healthcare Commission, the American College of Gastroenterology, the American Gastroenterology Association, and the International Foundation for Functional Gastrointestinal Disorders connects the importance of the soundness of the gastrointestinal tract to overall physical and mental health.

With the outpouring of research on the total health of seniors and gastrointestinal illness over the years, senior care facilities have begun to collaborate more with nutritionists/dietitians, gastrointestinal specialists/gastroenterologists, surgeons, critical care nurses, activities directors, exercise specialists, physical therapists, occupational therapists, message therapists, medical assistants and radiologists to treat and rehabilitate their patients.

The digestive tract includes the mouth, teeth, esophagus, stomach, small and large intestines, rectum, anus, liver, pancreas and gallbladder. Care providers, researchers and policymakers say keeping the tract healthy is vital to good health, which means that each of these components must work properly.

Food is digested before it enters the small intestines where much of the process takes place between the enzymes in saliva and the stomach. More enzymes are made in the small intestines and pancreas. The remainder goes into the large intestine or the colon. Water is purged from what has not been digested.

However, with enzymes decreasing with age, digestion slows down as does, also, the body’s ability to take in nutrients. When this occurs, seniors start to lose benign bacteria, which leads to overuse of the liver and kidneys and courts a wide range of illnesses.

Symptoms of a deteriorating digestive tract include bloating, indigestion and constipation. As conditions worsen, so do the symptoms. Still, a malfunctioning tract can recover with proper nutrition. Enzymes to aid digestion can be bought in supplements to counteract bloating, indigestion and constipation.

Senior Care Concerns

In hospitals and senior care facilities, leadership-level dietitians advise directors of the nutrition department on management and development of clinical services and supervisors of the gastrointestinal surgery and critical care department on delivery, practice and design. These dietitians are expected to have extensive clinical nutritional experience and knowledge of gastrointestinal surgery and critical care.

In the case of seniors, they are aware that this cohort of patients face a unique set of health problems. Dietitians understand that the bodies of seniors differ from that of others and they are more vulnerable to a variety of illnesses and their attitudes towards health care are different as well.

Aging causes patients to change in body weight and composition as both men and women weigh more as they transition from young adult to middle age to senior adulthood. By their 70s, they start to lose weight. As they age, the bodies of seniors regulate blood pressure, body temperature and fluids less efficiently.

Illnesses in seniors can interrupt cell production. For instance, Alzheimer’s disease can lead to the early death of brain cells and Parkinson’s disease can eliminate an excessive number of nerve cells. By comparison, cancer delays cell death and enables cancer cells to proliferate.

The sum of these changes affect how a senior lives, the amount and the type of physical exercise he or she conducts as well as his or her health care needs.

Aside from the fact that seniors present a specific set of health concerns, no single aging adult has the same problems. No two seniors age at the same rate. Additionally, even within one senior, not all body systems changes are entirely synchronized.

Seniors process medicines, whether herbal or pharmaceutical, differently than young and middle-aged adults.

Seniors weigh less and have more body fat than they have muscle. As the percentage of body fat increases, the bodies of seniors metabolize drugs and other substances in fatty tissue, which means that these elements stay in their bodies longer and may be more stronger than similar medications in the bodies of young and middle-aged adults.

These medications collect in the bodies of seniors because their kidneys don’t function as effectively as they did when they were younger adults. As a result, for example, nonsteroidal anti-inflammatory drugs, also known as NSAIDs, are more at risk of causing gastrointestinal bleeding and kidney trouble in seniors than in young or middle-aged adults.
Gastrointestinal Health

Especially after a gastrointestinal surgical procedure or therapy, dietitians provide senior patients with advice about improving their health. While a variety of reasons exist for poor gastrointestinal health, food is the main one.

As a result, dietitians recommend that seniors prevent a range of digestive diseases, including gastrointestinal ones, by eating properly. This means eating a balanced diet of protein, carbohydrates and fats, fresh foods and fiber-rich fruits and vegetables.

A balanced diet clears the intestines, improves bowel movements and decreases constipation. Whole wheat carbohydrates are more fiber-rich than white-flour-based ones.

Seniors are encouraged to consume five portions of fruit and vegetables per day as part of the recommended daily intake with research revealing that this habit guards against life-threatening illnesses such as cancer and maintains a healthy digestive tract.

They are advised to drink fresh and uncontaminated water, specifically two liters, which does not include coffee, tea or carbonated drinks, to stay hydrated and flush out poisons. Two liters equals six glasses daily. Habitual coffee drinkers are asked to remember to drink a glass of water after each cup as coffee has a dehydrating effect on the body.

In an age of national fracking and offshore oil and gas drilling, private home walls tainted by lead paint, radon gas seeping underground, carbon monoxide in homes and garages and electromagnetic waves emanating from nearby electrical poles and generators and other forms of environmental pollution, activities such as drinking safe, purified water becomes more critical to gastrointestinal health.

Tainted water contains bacteria, which may damage the intestines and destroy the digestive system, leading to vomiting and diarrhea.

Additionally, dietitians ask senior patients to steer clear of spicy foods. Extra spices cause high acidity and alkaline content in the intestines, kidney problems requiring dialysis and severe burning.

High acidity can be halted by consuming such foods sparingly, keeping the blood stream at a pH of 7.4 and using liver salts. For similar reasons, seniors are asked to avoid sour foods.

They are cautioned to eat light meals every two hours or to generally eat little but often and to space meals apart daily. Eating a large meal within hours of sleep for the night should be avoided.

Such practices, dietitians say, improve gastrointestinal health by decreasing the burden on the liver and the small intestine from which the blood supply declines and absorption of the nutrients from large amounts of food is made more difficult.

Seniors are also recommended to shy away from foods containing high fat, including deep-fried foods, and to adopt a low-fat diet instead. Avoiding high fat in the diet, dietitians say, prevents the development of gall stones.

Patients are told to cease smoking and drinking excess alcohol, as both or either lead to the formation of small sores in the stomach known as ulcers, compromising gastrointestinal health.

While seniors are prescribed a cocktail of painkillers and anti-inflammatory medication, they are instructed to avoid excess as these, too, lead to stomach ulcers.

Seniors are also advised to stop eating foods that cause allergies and this habit will lead to sounder gastrointestinal health. Symptoms include vomiting, itchy spots on the skin and reddishness around the mouth.

They are asked to take part in a moderate amount of daily exercise, especially those related to the abdomen, yoga or relaxation through message therapy as these are the means of ensuring sound gastrointestinal health and avoiding mental stress. Mental stress leads to gastrointestinal illness, particularly acidity in the stomach and ulcers.

Swimming is ideal as a form of exercise because it not only keeps a patient fit but also tones all the major muscle groups of the body.

Dietitians say sufficient hours of sleep and sleeping at the same time every night also leads to optimal gastrointestinal health as insufficient sleep leads to depression, which triggers unsoundness eating habits that compromise gastrointestinal health.

Gastrointestinal Exams, Programs

Physicians also recommend that seniors, especially those with gastrointestinal problems, participate in specific radiological health programs that include esophageal and anorectal manometry, pelvic muscle retraining, also known as biofeedback, and defecography.

The NCI and the American College of Gastroenterology report that colon and rectum cancers are the fourth most commonly diagnosed cancers and are second among cancer deaths nationally. Screening for colorectal cancer is regularly permitted by most insurers for patients aged 50 years or older and patients with family histories of cancer.

Some common gastrointestinal exams include colonoscopy, liver biopsy, paracentesis, esophagogastroduodenoscopy (EGD), endoscopic retrograde cholangiopancretography (ERCP), endoscopic ultrasound, and percutaneous endoscopic gastrostromy (PEG). Pulmonary tests include bronchoscopy, thoracentesis, bracheotherapy and tracheostomy. Other programs include photodynamic therapy.

Symptoms that warrant a esophageal motility study (EMS) include heart burn, difficulty swallowing, unexplained chest pain, pre-operative evaluation, anti-reflux surgery and diagnostic tool to identify scleroderma, achalasia and nutcracker esophagus.
Conditions that qualify for 24-hour pH monitoring include heart burn, difficulty swallowing, unexplained chest pain, chronic cough and hoarseness.

Problems that satisfy the need for anorectal motility with electromyography (ARM w/EMG) include evaluation of fecal incontinence, chronic constipation, evaluation of rectal pain, retraining on incontinence, pre-operative evaluation, rectal surgery and anal surgery.

To undergo radiological defecography, senior patients must present with the symptoms of prolapsed rectum, intussusception and enterocele. To receive pelvic muscle retraining, patients must exhibit symptoms of fecal incontinence, chronic constipation, difficult evacuation and anal pain.

Physicians also steer senior patients, who experience bleeding, pain, swallowing difficulties and a change in bowel movements, in the direction of endoscopy services that include non-invasive gastrointestinal and pulmonary procedures that last an hour to three hours on an outpatient basis.

Endoscopy involves examining inside the human body with an endoscope, a flexible tube holding a small camera. The type of endoscope used is named for the organs of the body they are meant to examine such as an arthroscope for the joints, a bronchoscope for the lungs, cystoscope for the bladder and a laparoscope for the abdomen.

A gastrointestinal endoscope is inserted through the mouth or anus or rectum and an ultrasound probe can be added to the endoscope, thus called an endoscopic ultrasound.

Small instruments can be used to take samples of possibly diseased tissues. Probes that pertain to the gastrointestinal tract include colonoscopy for colon polyps or colon cancer, EGD or esophagogastroduodenoscopy, enteroscopy and sigmoidoscopy. A patient may be asked to clear out his or her large intestine by enemas and laxatives to prepare for these tests.

For senior patients suffering from diarrhea, physicians may may also order fecal smears, a lab test to inspect a stool sample for bacteria, fungi, viruses or other type of microorganisms that start illnesses in the gastrointestinal tract.

There are multiple ways to collect the sample. One is to capture it in plastic wrap in a washroom and keep it in a clean container in the doctor’s office. Once the physician receives the results of the lab test, he or she can prescribe the most appropriate antibiotic treatment.

Doctors can also direct senior patients to take a rectal culture, a lab test to determine the type of microorganisms that cause gastrointestinal illnesses. With this type of test, a cotton swab is placed in the rectum, turned around and retrieved. A smear is used to grow bacteria or other organisms to observe the culture for growth.

The culture may be carried out in a hospital or nursing home to test a senior patient for vancomycin-resistant enterococcus or VRE in their intestine, a highly communicable disease.

Gastrointestinal Gas

Gastrointestinal gas is defined as flatus or gas eliminated by burping or passing through the rectum. Research finds that individuals produce a normal quota of about one to three pints a day and experience flatulence 14 times a day though some believe they release too much.

The gas is made mostly of odorless substances, carbon dioxide, nitrogen, hydrogen and oftentimes methane. Foods containing carbohydrates cause gas while foods with fats and protein cause little.

The unpleasant scent stems from bacteria in the large intestine that emit gases containing sulfur. The gas comes from swallowed air and the breakdown of undigested foods by benign bacteria in the large intestine.

Air swallowed by a person is also known as aerophagia. Any person can swallow air when eating and drinking. Still, eating and drinking quickly, chewing gum, drinking with a straw, smoking and wearing loose dentures can cause some individuals to breathe in more.

Symptoms of gas include belching, flatulence and abdominal bloating and pain. Crucial factors are likely how much gas the body eliminates and an individual’s sensitivity to gas in the large intestine.

However, large amounts of flatus may signal an abnormality in which the intestine absorbs nutrients, especially if diarrhea or weight loss is present.

While eliminating gas is a healthy, daily digestive process, physicians recommend the omission of certain foods, including high-fat ones, from a patient’s diet to cut down on bloating and discomfort. Scaling back enables the stomach to empty more quickly, letting gas move onto the small intestine.

Gas-emitting foods include broccoli, baked beans, beer, brussels sprouts, cabbage, carbonated drinks, cauliflower, chewing gums, citrus fruits, corn, eggs, greens, milk products, oats, onions, potatoes, red wine and wheat. Doctors also recommend the start of a lactose-free diet to cut down on human gas emissions.

Enzymes such as lactase supplements aid digestion of carbohydrates and empower individuals to eat foods that produce gas. For example, the enzyme product Beano cuts down on gas production connected with baked beans.

Decreasing the amount of air swallowed or aerophagia is also presented as a solution. Aerophagia is associated with excess salivation and many physicians recommend avoiding such habits as too much gum chewing or smoking. They also seek to treat such digestive conditions as peptic ulcer, which may lead to hypersalivation or nausea.