Gastrointestinal Tract in the Aged.

Intro -- GASTROINTESTINAL TRACTIN THE AGED -- GASTROINTESTINAL TRACTIN THE AGED -- Contents -- Preface -- Chapter IEpidemiology of the Elderly -- Abstract -- Introduction -- Demographic Changes in theWorld Population -- Demographic Changes in theElderly Population -- Gastrointestinal TractEpidemiology in the Elderly -- References -- Chapter IIThe Physiology of GI Tract in the Aged -- Purpose of Review -- Highlights -- Summary -- Introduction -- Alteration in Chemosensory Function -- Physiologic Anorexia of Aging:Physiological or Patholigical Process -- Post Prandial Hypotension -- Silent Aspiration Syndromes -- Gastrointestinal Motility Changes in Aging Gut -- Changes in Gastric Mucosa,Acid Production, and Gut Flora -- Intestinal Absorption -- Aging Liver: Regeneration Capacity and Effectson Drug Metabolism -- Pancreatic Changes Observed with Aging:Effect on Carbohydrate Metabolism -- References -- Chapter IIIGastrointestinal MotilityDisturbances in the Elderly -- Introduction -- Control of Upper Gastrointestinal Motility -- Age-Related Changes in theEnteric Nervous System -- Esophagus -- Effects of Healthy Aging -- Disorders of Esophageal Function in the Elderly -- Achalasia -- Diffuse Spasm and "Nutcracker" Esophagus -- Non-Specific Motility Disorders -- "Pill" Esophagitis -- Gastro-Esophageal Reflux Disease -- Stomach -- Small Intestine -- Specific Disorders that AffectGastrointestinal Function in the Elderly -- Parkinson's Disease -- Diabetes Mellitus -- Functional GastrointestinalDisorders in the Elderly -- Non-Cardiac Chest Pain -- Summary -- Acknowledgment -- References -- Chapter IVNutrition in the Elderly -- Abstract -- The Aging Population and itsSpecial Health Problems -- The Impact of Nutritionon the Aging Process -- The Impact of Energy Restriction -- Age Related Physiological ChangesLeading to Nutritional Deficiencies.

Gastrointestinal Changesand Nutrition with Aging -- Changes in Other SystemsAffecting Nutrition with Aging -- The Role of Illness and Comorbidity -- Determination of NutritionalDeficiencies in the Elderly -- Protein and Energy Deficiencies in Elderly -- Protein Energy Malnutritionand Sarcopenia of Aging -- Definition of Sarcopenia in the Elderly -- The Causes of Sarcopenia in the Elderly -- 1. Endocrine and Metabolic Causes of Sarcopenia -- 2. Physical Activity and Sarcopenia -- Micronutrient Deficiencyand Borderline Deficiency -- Zinc Deficiency -- Iron Deficiency -- Vitamin B12 and Folate Deficiencies -- Pyridoxine -- Riboflavin Deficiency -- Fat Soluble Vitamins -- Antioxidant Vitamins -- Clinical Symptoms of Malnutrition -- Prevalence of Deficiencies inDifferent Populations -- Active Enteral Nutrition Support -- Ethical Consideration in Making the Decisionon Active Enteral Nutrition Support -- References -- Chapter VChronic Constipation in the Elderly -- Epidemiology -- Definition of Chronic Constipation -- Risk Factors for Constipation in the Elderly -- Types of Constipation -- Primary or Idiopathic Constipation -- Diagnosis -- Management of ChronicConstipation in the Elderly -- Bulk (Fiber) Laxatives -- Osmotic Laxatives -- Stimulant Laxatives -- Stool Softeners -- Enemas and Suppositories -- Biofeedback -- New Therapies for Chronic Constipation -- Chloride Channel Activators -- Serotonergic Prokinetic Agents -- Guanylate Cyclase C Activators -- Peripheral Opioid Antagonists -- Conclusion -- References -- Chapter VIDiseases of the Stomach in the Aged -- Introduction -- Gastric Anatomy andPhysiology in the Elderly -- Helicobacter Pylori -- Gastritis -- Gastric Polyps -- Peptic Ulcer Disease -- Presentation -- Etiology -- Treatment -- Complications -- Hemorrhage -- Perforation -- Gastric Outlet Obstruction -- Penetration -- Malabsorption.

Vitamin B12 -- Iron -- Calcium -- Feeding Tubes andNutritional Support -- Gastric Bypass -- Medications -- Proton Pump Inhibitors -- H2 Receptor Antagonists -- Prostglandin E1 Analogs -- Helicobacter Pylori Treatment -- Iron and Potassium Supplementation -- Conclusion -- References -- Chapter VIISmall Bowel Diseases in the Elderly -- (1.) Biological Basics - Age-Related Changes -- (1.1) Histological Changes -- (1.2.) Physiological Changes -- (1.3.) Immunological Changes -- (2.) Symptoms and Signs -- (2.1.) Abdominal Pain -- (2.2.) Diarrhoea -- (2.2,1.) Definition -- (2.2.1.1.) Predisposing Factors to Acute, InfectiousDiarrhoea Concerning Elder Patients -- (2.2.1.2.) Differential Diagnosis -- (2.2.2.) Classification -- (2.2.2.1.) by Duration -- (2.2.2.2.) by Pathogenic Mechanism -- (2.2.2.2.1.) Osmotic Diarrhoea -- (2.2.2.2.2.) Secretory Diarrhoea -- (2.2.3.) Inflammation -- (2.2.4) Practical Approach -- (2.3.) Malabsorption -- (2.3.1.) Definition -- (2.3.2.) Malabsorption and Aging -- (2.3.3.) Pathophysiology and Etiology -- (2.3.4.) Specific Clinical Signs -- (2.3.4.1.) Megaloblastic Anemia -- (2.3.4.2.) Neurological Signs of Malabsorption -- (2.3.4.3.) Osteoporosis/Osteomalacia -- (2.3.4.4.) Skin Manifestations -- (2.3.4.5.) Flatulence and Bloating -- (2.3.4.6.) Other Manifestations of Malabsorption -- (2.3.5.) Practical Approach to Malabsorption in the Elderly -- (2.3.6.) Treatment of Malabsorption -- (2.3.6.1.) Correcting Deficiencies -- (2.3.6.2.) Treatment of Underlying Causes -- References -- Chapter VIIIDisease of the Pancreasand Biliary Tractin the Elderly -- Introduction -- Endoscopic versus Radiologic Approaches to Hepatobiliary disease -- Radiologic Approach -- Endoscopic Approach -- Indications for Endscopy -- Cholangitis -- Obstruction -- Risks of Endoscopy -- Avoiding Unnecessary Procedures -- Pre-Procedural Evaluation -- Sedation.

Management of Anticoagulation -- Pacemaker Evaluation -- Evaluation of Pancreatitis -- Pancreatic Insufficiency -- Work up of Pancreatic Insufficiency -- Summary -- References -- Chapter IXLiver Diseases in the Elderly -- Introduction -- Age Related Changes in Structureand Function of the Liver -- Epidemiology of Chronic LiverDisease in Advanced Age -- Viral Hepatitis - HCV Infection -- Non Alcoholic Fatty Liver Disease (NAFLD) -- Autoimmune Hepatitis -- Liver Transplantation in the Elderly -- Pretransplant Evaluation of Older TransplantCandidates: -- Chronic Hepatitis B in the Elderly -- References -- Chapter XInflammatory Bowel Diseasein the Elderly -- Introduction -- Epidemiology -- Etiology and Pathogenesis -- Pathology -- Clinical Manifestations -- Signs and Symptoms -- Laboratory Abnormalities -- Disease Location -- Disease Behavior -- Extra Intestinal Manifestations -- Complications -- Differential Diagnosis -- Treatment -- 5-Aminosalicilic Acid (5ASA) -- Glucocorticosteroids -- Azathioprine (AZA) and 6-Mercaptopurine (6-MP) -- Methotrexate (MTX) -- Cyclosporine A (CSA) -- Anti TNF-α Antibodies -- Antibiotics -- Additional Therapies -- Prognosis and Outcome -- References -- Chapter XIDiverticular Disease in the Elderly -- 1. Definition -- 2. Epidemiology -- 3. Etiology -- 4. Pathophysiology -- 5. Natural History and Complications -- A. Acute Diverticulitis -- I. Mechanism and Natural History -- II. Diagnosis and Evaluation -- III. Treatment -- IV. Complicated Acute Diverticulitis -- B. Diverticular Hemorrhage -- 6. Special Conditions -- A. Recurrent Diverticulitis after Colonic Resection -- B. Right Sided Diverticulitis -- C. Diverticulitis in Immune Compromised Patients -- References -- Chapter XIICancer in the Geriatric Age:G-I Cancer in the Aging -- Introduction -- Decision Capacity in the Elderly -- Colon Cancer.

Chemotherapy in Elderly Patients with CRC -- SURGERY FOR LIVER METASTASESIN THE ELDERELY -- GASTRIC and ESOPHAGEAL CANCER -- PANCREATIC CANCER -- Summary -- References -- Index -- Blank Page.

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