Health & Fitness

Eating more fiber and staying active can ease digestive woes as you age

FOR THE MIAMI HERALD

Indigestion, acid reflux, severe constipation and colon cancer affect all ages, but especially the elderly.

“Any part of the gastrointestinal tract can be affected by aging,” said Dr. Marc Lederhandler, gastroenterologist at Baptist Health Galloway Endoscopy Center. “Aging in the colon is the most common.”

Lower GI bleeding, diverticulosis and colon cancer are issues that affect older people, he noted. Regular screenings are the key to good colon health.

One-third of people grow polyps by age 50 — and 98 percent of colon cancer starts in benign polyps. The size and number of polyps dictate “whether we repeat a colonoscopy in three months or three years,” he said.

More serious issues are lower GI bleeding, diverticulosis coli. and colon cancer.

Diverticulitis, pouches that form in the colon’s wall, can become complicated by infection, with treatment ranging from antibiotics to surgery and blood transfusions.

Lederhandler said that outside factors like diabetes and tobacco can age patients even more. Medications, including pain medications, can lead to constipation, also caused by dehydration, lack of exercise and an overall slowdown in digestion that comes with age.

“I can’t prescribe one diet or exercise program, but avoiding alcohol and tobacco are important,’’ Lederhandler said. “A fiber-rich diet is a good way to go, but it does not substitute for regular screening.”

David Kofler, 89, was experiencing constipation despite his diet and exercise.

“I’ve always eaten a lot of vegetables and fish, and in recent years I’ve slacked off on meat,” said Kofler, who walks on a treadmill multiple times a week.

His doctor, Dr. Gabriel Gavrilescu, who specializes in internal medicine in geriatric patients at Cleveland Clinic Florida in Weston, said constipation happens more frequently in people over 65, and that it’s more prevalent in women. Doctors worry about constipation because it can be a sign of colon cancer.

“I always like to talk about prevention. [The colonoscopy] is the gold standard of care, and at age 50, everyone should have one,” he said.

When treating constipation, he assesses the need for every medication and makes sure that patients are drinking enough water.

“Next, we make sure they have adequate fiber in their diet. Most of the time, we recommend natural ones like beans, vegetables, apples, cereals, bran muffins,” he said.

Issues in the digestive tract start from the moment food, drinks and medications enter the body.

Dr. Leon Maratchi, gastroenterologist with Memorial Healthcare System, said calcium absorption in the small intestine decreases with age, which leads to osteoporosis. Even the liver, which detoxifies medicine, affects the digestive tract as you age.

“The elderly often take medications that need to be metabolized in the liver, and those can build up,” Maratchi said.

Acid reflux, heartburn and difficulty swallowing also increase with age. The lining of the stomach is less protective when you’re older, Maratachi said, noting it’s important to change your diet as needed and avoid lying down right after eating.

Lederhandler tells his patients to avoid caffeine, alcohol, chocolate, peppermint, citrus and carbonated beverages; he also recommends avoiding eating foods within three hours of lying down.

A swallowing impairment is also an issue, noting that more than 70 percent of people over the age of 65 have this condition, Gavrilescu said.

“It can cause cough or aspirations,” Maratchi said. “Some people need speech therapy to help them strengthen the muscles in the back of the throat.”

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