Gastrointestinal Disorders in Elderly Patients
Section snippets
Swallowing disorders
Swallowing is an essential biologic function, and any alteration can have severe consequences, such as malnutrition, dehydration, aspiration pneumonia, or airway obstruction. Swallowing disorders have a variety of causes: neurologic disease; neoplasia of the oral cavity, the pharynx and/or the larynx; connective tissue disease; trauma; infection; or iatrogenic illness.
Because dysphagia covers a wide range of symptoms, from a vague or subtle sensation of abnormal swallowing in an ambulatory,
Pelvic floor pathologies
In recent years, diagnostic imaging has renewed interest in the study of morphofunctional disorders characterizing pelvic floor pathologies.
Because of the multiplicity of these disorders and the variety of symptoms (which are not related easily to individual diseases and which present in various associations of symptoms), the clinical examination, although necessary as a first approach to the problem, often is insufficient to define the nature of the disorder. Furthermore, it is common for a
Acute abdomen
Elderly patients who have acute abdomen are much less likely to have the classic presentation of this syndrome. Some differences in presentation of the acute abdomen are caused by age-associated physiologic changes. An aged immune system has a decreased ability to react to common insults, so elderly patients are less likely to have fever or leukocytosis. Their pain often is much less severe than would be expected for a particular disease, because decreased neural sensitivity causes reduced
Acute small bowel obstruction
An SBO is one of the most common causes of admission in emergency departments. The leading cause of SBO in developed countries is postoperative adhesions (60%), followed by malignancy, Crohn's disease, and hernias. Based on surgical and imaging findings, SBOs can be classified as simple, unbalanced, or complicated.61
Simple obstruction is characterized by a “bowel picture,” and has the most favorable patient prognosis and outcome. In these patients nonoperative management is the first-line
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