The document discusses the effects of aging on the digestive system. It states that as people age, the esophagus and stomach are less able to contract strongly and accommodate large amounts of food. Absorption in the small intestine changes little with age, but lactase production decreases, causing lactose intolerance. The liver shows some functional decline with aging as well. The document provides details on specific changes that occur in different parts of the digestive system as people get older.

1. Lets get healthy
Dr Sanjiv Haribhakti, MS, DNB, MCh (GI Surgery)
Kaizen hospital, 132 ft ring road, Nr helmet circle,
Memnagar, Ahmedabad-380052

2. The digestive system

3. Effect of aging on digestive system
Esophagus
• With age, the strength of esophageal contractions and the
tension in the upper esophageal sphincter decrease, but the
movement of food is not impaired by these changes
• However, many older adults are likely to be affected by diseases
that interfere with esophageal contractions

4. Effect of aging on digestive system
Stomach
• Stomach lining's capacity to resist damage decreases, which in
turn may increase the risk of peptic ulcer disease, especially in
people who use aspirin and other nonsteroidal anti-inflammatory
drugs (NSAIDs)
• Stomach cannot accommodate as much food (because of
decreased elasticity), and the rate at which the stomach empties
food into the small intestine decreases
• 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, become more common

5. Effect of aging on digestive system
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)
• Excessive growth of certain bacteria 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 folic acid, iron, and calcium

6. Effect of aging on digestive system
Pancreas and Gallbladder
• 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 gallbladder age, a number of structural and microscopic
changes occur

7. Effect of aging on digestive system
Liver
• The color of the liver changes from lighter to darker brown. Its size and blood flow
decrease. However, liver function test results generally remain normal
• The ability of the liver to metabolize many substances decreases with aging. Thus,
some drugs are not inactivated as quickly in older people as they are in younger
people
• the liver's ability to withstand stress decreases. Thus, substances that are toxic to the
liver can cause more damage in older people than in younger people
• Repair of damaged liver cells is also slower in older people.
• The production and flow of bile decrease with aging. As a result, gallstones are more
likely to form

8. Effect of aging on digestive system
Large Intestine & Rectum
• The large intestine does not undergo much change with age
• The rectum does enlarge somewhat
• Constipation becomes more common. This may be due partly to a
slight slowing in the movement of contents through the large
intestine and a modest decrease in the contractions of the
rectum when filled with stool

9. What is Acidity ?
• The stomach normally secretes acid that is essential in the
digestive process. This acid helps in breaking down the food
during digestion
• When there is excess production of acid by the gastric glands
of the stomach, it results in the condition known as acidity

10. How to avoid Acidity ?
• A suitable diet must be strictly followed avoiding spicy, salty and
acidic foods
• Smoking and alcohol consumption must be stopped
• Those with highly nervous and emotional disposition and those
involved in high-stress jobs must be encouraged to take lifestyle
modifying measures

11. How is GERD treated ?
Lifestyle changes
• Altering eating and sleeping pattern
• Eliminate smoking and alcohol consumption
• Weight reduction
Drug therapy
• Antacids - neutralize stomach acid
• PPI - reduce stomach acid production
Surgery
• Nissen fundoplication

12. Helicobacter pylori infection
• H pylori is a type of bacteria
that normally infect the
stomach
• It can lead to problems such
as ulcers developing in the
stomach or duodenum
• It is also associated with
stomach cancer and
an inflammation inside your
stomach known as gastritis

13. Symptoms of H pylori infection
• Abdominal pain
• Excessive burping
• Feeling bloated
• Feeling sick or vomiting
• Losing your appetite
• Losing weight

14. How to prevent H Pylori infection ?
• Work in ventilated area - allow for fresh air flow
• Wash your hands frequently and properly
• Only drink clean water from a reputable source
• Broccoli sprouts has shown to inhibit H Pylori *
• Eating cranberries, red grapes, and blueberries make H Pylori
grow much more slowly and changes the shape of the bacterium
into a coccoid form, so that it is no longer a helicobacter #
* http://www.ncbi.nlm.nih.gov/pubmed/19349290
# http://www.ncbi.nlm.nih.gov/pubmed/19120894

15. What is constipation ?
• Constipation occurs when bowel movements become difficult
or less frequent
• You are considered constipated if you have two or more of the
following for at least 3 months:
 Straining during a bowel movement > 25% of the time
 Hard stools > 25% of the time
 Incomplete evacuation > 25% of the time
 Two or fewer bowel movements in a week

16. Constipation - when to consult doctor ?
Call your doctor if:
• Constipation is a new problem for you
• You have blood in your stool
• You are losing weight even without dieting
• You have severe pain with bowel movements
• Your constipation has lasted more than two weeks

17. How to prevent constipation ?
• Eat a well-balanced diet with plenty of fiber. Good sources of
fiber are fruits, vegetables, legumes, and whole-grain bread
and cereal (especially bran)
• Drink 12 glasses of water everyday
• Fiber and water help the colon pass stool
• Exercise regularly

18. Treatment of UC
Lifestyle changes
• Limit dairy products
• Eat more fibers - vegetables, fruits, bran
• Take plenty of liquid
• Avoid stress
Drug therapy
• Anti inflammatory - sulfasalazine, mesalamine
• Immune suppressor - azathioprine, cyclosporin
Surgery
• Proctocolectomy

19. What is hernia ?
• A hernia occurs when there is a weakness or hole in the muscular
wall that usually keeps abdominal organs in place - the
peritoneum. This defect allows organs and tissues to push
through, or herniate, producing a bulge
• Hernias are caused by a combination of muscle weakness and
strain
• A hernia can develop quickly or over a long period of time,
depending on its cause

20. Treatment of hernia
• If the hernia is growing larger or causing pain, doctor may decide
that it’s best to operate
• Doctor may repair the hernia by patching the hole with surgical
mesh
• Hernias can be repaired with either open or laparoscopic surgery
• Laparoscopic surgery uses a tiny camera and miniaturized surgical
equipment to repair the hernia using only a few small incisions
• Laparoscopic surgery is less damaging to the surrounding tissue

21. What are piles ?
• Piles are swollen blood vessels in or around the anus and rectum
• The haemorrhoidal veins are located in the lowest part of the
rectum and the anus
• Sometimes they swell so that the vein walls become stretched,
thin, and irritated by passing bowel movements

22. Why do piles occur ?
• The blood vessels around the anus and in the rectum will stretch
under pressure and may swell or bulge
• Inflamed veins (hemorrhoids) can develop when pressure increases
in the lower rectum. This may be due to:
• Chronic constipation
• Chronic diarrhea
• Lifting heavy weights
• Pregnancy
• Straining when passing a stool

23. How to prevent piles ?
• A change in diet can help keep the stools regular and soft. This
involves eating more fiber, such as fruit and vegetables, or switching
your cereal breakfast to bran
• losing weight may help reduce the incidence and severity of
hemorrhoids
• Try not to strain when you go to the toilet
• Avoid laxatives
• Exercise

24. Surgery to cure piles
• Used for particularly large piles, or grades 3 or 4 hemorrhoids
• Hemorrhoidectomy - the excess tissue that is causing the bleeding is
surgically removed. It is the most effective in completely removing
piles, but there is a risk of complications, such as difficulties passing
stools, as well as UTI
• Hemorrhoid stapling - blood flow is blocked
to the tissue of the hemorrhoid. It is usually
less painful. However, there is a greater risk
of hemorrhoid recurrence and rectal
prolapse (part of the rectum pushes out of
the anus)

25. What is cancer ?
• Normal cells multiply when the body needs them, and die when the
body doesn't
• Cancer appears to occur when the growth of cells in the body is out
of control and cells divide too rapidly
• It can also occur when cells “forget” how to die
• There are many different kinds of cancers

26. Most common cancers in India
28
17
12
7
30
13 12
6
4
0
5
10
15
20
25
30
35
Prostate
cancer
Breast cancer Lung cancer Colorectal
cancer
Bladder
cancer
Uterus
cancer
Ovary cancer
Men Women

27. Most common GI cancers
Colorectal cancer
Esophageal cancer
Pancreatic cancer
Stomach cancer Liver cancer

28. Risk factors of cancer ?
There are multiple risk factors of cancers, including:
• Radiation
• UV light
• Tobacco
• Certain viruses
• Benzene
• Genetic / Hereditery

29. Early detection of cancer
• Early detection of cancer greatly increases the chances for successful
treatment
• There are two major components of early detection of cancer:
• Education to promote early diagnosis
• Screening

30. Education to promote early diagnosis of cancer
• Recognizing possible warning signs of cancer and taking prompt
action leads to early diagnosis
• Increased awareness of possible warning signs of cancer can have a
great impact on the disease
• Some early signs of cancer include:
• lumps
• sores that fail to heal
• abnormal bleeding per rectum
• persistent indigestion
• chronic hoarseness
• Difficulty in swallowing

31. Screening to promote early diagnosis of cancer
• Screening refers to the use of simple tests across a healthy
population in order to identify individuals who have disease, but do
not yet have symptoms
• breast cancer screening using mammography
• cervical cancer screening using cytology screening methods
including Pap smears
• Colorectal cancer screening using colonoscopy
• UGI cancer screening using UGI endoscopy

32. Lifestyle diseases
•Lifestyle Diseases
are diseases that
are caused partly by
unhealthy behaviors
and partly by other
factors

33. Today's lifestyle
Abundance of fats & sugar Change in work culture
Lack of Physical Exercise Emotional Distrubances

34. Most common lifestyle diseases
• CVDs
• Diabetes Mellitus
• COPD
• Cancer
• Asthma
• Disease of Digestive System (Peptic Ulcers, GERD)
• Genitourinary Conditions (Nephritis, CKD)
• Neuro-Psychiatric Disorders (Depression, Anxiety, Stress)
Top 4 Lifestyle Diseases in India

35. Obesity has reached alarming figures
• More than 25% of Indians are overweight
• More than 3% are Obese (3 crores Indians)
• > 5% of urban adults are obese
• > 15% of urban children are overweight

36. Complications of obesity

37. Surgery for morbid obesity
Gastric Sleeve
Gastric Bypass Gastric Band

38. Planning a meal
• Proportions and timings are important
• Portions at each meal should be balanced and proportionate
• Eat at regular intervals
08:00 AM 10:30
AM
01:00 PM 04:00
PM
08:00 PM
09:30
PM
Size of circle indicates size of meal

39. Health benefits of yoga & exercise
• Yoga has been practiced for more than 5000 years
• Speeds up a Sluggish Digestion by massaging surrounding muscles
• Increases Muscle Flexibility, Strength & Endurance
• Relieves Stress & Anxiety
• Boost positive Energy and Mood
• Help normalize Blood Pressure
• Increases feelings of Calm & Wellbeing

40. Health benefits of meditation
• It can reverse the Stress Response, thereby provides a shield against
the effects of Chronic Stress
• Heart Rate and Breathing slows down, Blood Pressure normalizes
• Oxygen can be used more efficiently
• Adrenal glands produce less Cortisol
• Mind ages at a slower rate
• Improves Immune Function

41. Use Stairs more often
Gardening & Leisurely activities
Self clean the house at least weekly
Stay physically active

42. Stay physically active
Clean the Car by hand Play with children everyday
Take optimum sleep of 8 hours
too much sleep can also cause fatigue

43. stay happy
stay healthy