Basic Mechanisms of the Aging Gastrointestinal Tract

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Abstract

The goal of this short review is to summarize recent data on gastrointestinal changes with aging, focusing on gastrointestinal motility disorders, and mucosal variations. First of all, this review focused on gastrointestinal motility disorders with aging, even though an increased prevalence of several gastrointestinal motor disorders (i.e., dysphagia, dyspepsia, anorexia, and constipation) occurs in older people, aging per se appears to have a minor direct effect on most gastrointestinal functions. Secondly, this review focused on histological changes with aging, i.e., regulation of gastrointestinal mucosal growth, gastrointestinal carcinogenesis, and gastric mucosal changes, especially changes in gastric acid secretion, bacterial overgrowth and its consequences on elderly patients.

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Most cited references 29

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The stomach is a source of leptin.

A Bado, S Levasseur, S Attoub … (1998)

The circulating peptide leptin, which is the product of the ob gene, provides feedback information on the size of fat stores to central Ob receptors that control food intake and body-weight homeostasis. Leptin has so far been reported to be secreted only by adipocytes and the placenta. Here we show that leptin messenger RNA and leptin protein are present in rat gastric epithelium, and that cells in the glands of the gastric fundic mucosa are immunoreactive for leptin. The physiological function of this previously unsuspected source of leptin is unknown. However, both feeding and administration of CCK-8 (the biologically active carboxy-terminal end of cholecystokinin) result in a rapid and large decrease in both leptin cell immunoreactivity and the leptin content of the fundic epithelium, with a concomitant increase in the concentration of leptin in the plasma. These results indicate that gastric leptin may be involved in early CCK-mediated effects activated by food intake, possibly including satiety.

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Effects of ageing on gastrointestinal motor function.

Craig J. Graff, Eugene Madsen (2004)

Existing data on the effect of ageing on gastrointestinal motility are few. In this study, we assessed the propulsive effect of all main segments of the gastrointestinal tract in a group of healthy older people. 16 healthy volunteers (eight women, eight men) of mean age 81 years (range 74-85 years) participated in the study. Gastric emptying and small intestinal and colonic transit rates were determined by gamma camera technique. The technique was also used to measure the postprandial frequency of antral contractions. Furthermore, we assessed the effects of gender, body mass index and smoking on the motility variables. The results were compared with data from 16 healthy individuals (eight women, eight men) of mean age 24 years (range 20-30 years). Advanced age did not influence gastric emptying or small intestinal transit rate. Older individuals had a slower colonic transit than young individuals (P = 0.0008). No difference was found in postprandial frequency of antral contractions between older and young subjects. None of the motility variables was affected by gender or body mass index. Smokers had a faster colonic transit than non-smokers (P = 0.0022). Normal ageing seems to reduce the propulsive capacity of the colon, whereas gastric and small intestinal motility is not affected.

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Plasma ghrelin following cure of Helicobacter pylori.

C U Nwokolo, D A Freshwater, P O'Hare … (2003)

In the Western world, the incidence of oesophageal adenocarcinoma has increased over the last 30 years coinciding with a decrease in the prevalence of Helicobacter pylori. Trends of increasing oesophageal adenocarcinoma can be linked causally to increasing gastro-oesophageal reflux disease (GORD) which can be linked to an increasingly obese population. However, there is no plausible biological mechanism of association between H. pylori, obesity, and GORD. Ghrelin, a peptide produced in the stomach, which regulates appetite, food intake, and body composition, was studied in H. pylori positive asymptomatic subjects. Plasma ghrelin, leptin, and gastrin were measured for six hours after an overnight fast, before and after cure of H. pylori in 10 subjects. Twenty four hour intragastric acidity was also assessed. After cure, median (95% confidence intervals) integrated plasma ghrelin increased from 1160.5 (765.5-1451) pg/ml x h to 1910.4 (1675.6-2395.6) pg/ml x h (p=0.002, Wilcoxon's rank sum test), a 75% increase. This was associated with a 14% increase in 24 hour intragastric acidity (p=0.006) and non-significant changes in leptin and gastrin. There was a significant positive correlation between plasma ghrelin and intragastric acidity (r(s) 0.44, p=0.05, Spearman's rank correlation). After H. pylori cure, plasma ghrelin increased profoundly in asymptomatic subjects. This could lead to increased appetite and weight gain, and contribute to the increasing obesity seen in Western populations where H. pylori prevalence is low. This plausible biological mechanism links H pylori, through increasing obesity and GORD, to the increase in oesophageal adenocarcinoma observed in the West.

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Author and article information

Journal

Journal ID (publisher-id): DDI

Journal ID (nlm-ta): Dig Dis

Journal ID (doi): 10.1159/issn.0257-2753

Title: Digestive Diseases

Publisher: S. Karger AG

ISBN: 978-3-8055-8273-5

ISBN: 978-3-8055-8161-5

ISSN (Print): 0257-2753

ISSN (Electronic): 1421-9875

Publication date Subscription-year: 2007

Publication date (Print): April 2007

Publication date (Electronic): 04 May 2007

Volume: 25

Issue: 2

Pages: 112-117

Affiliations

Geriatric Department, Hospital Xavier Arnozan, Pessac, France

Article

Publisher ID: 99474 Other ID: Dig Dis 2007;25:112–117

DOI: 10.1159/000099474

PubMed ID: 17468545

SO-VID: 1040d919-29f9-475a-a386-bd6b945ca540

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Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher. Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug. Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.

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