Aging and the gastrointestinal tract

The aim of the present review is to summarize the most recent progress in g astroenterological topics, particularly of the upper gastrointestinal tr ac t, which are of special interest in the elderly. The changes in oesophageal function, particularly disorders of motility: may explain, only in part, t he unique clinical characteristics of oesophageal pathologies in the elderl y! Dysphagia and gastro-oesophageal reflux disease present diagnostic, clin ical and therapeutic characteristics that need to be studied with attention to avoid eventual disability, an impairment of nutritional status and a re duction in;the quality of life. Aging, per se, does not significantly modif y, gastric aggressive factors, however a selective and specific reduction i n some gastric defensive mechanisms seems to occur with aging. The preventi on of gastric mucosal injury, particularly that due to drugs, requires a be tter understanding of these age-related changes. Helicobacter pylori infect ion in the elderly presents peculiar epidemiological aspects particularly f or subjects living in nursing homes, An understanding of Helicobacter pylor i-related histological modifications of the gastric mucosa, particularly in testinal metaplasia, gastric atrophy and gastric cancer, the incidence of a which seems to be both age- and Helicobacter pylori-related: is greatly ne eded. Moreover; some diagnostic and therapeutic aspects of Helicobacter pyl ori infection, i.e., the role of serology and the efficacy: side effects an d compliance of drug therapies, are specific for the elderly and require a unique clinical approach. Bleeding is dramatically more frequent in this po pulation. Prevention is the key to reducing morbidity and mol mortality! Th e identification of risk factors, i.e,, drugs, pathophysiological mechanism s, i.e., the possible I relationship between non-steroidal anti-inflammator y drugs and Helicobacter pylori infection, along with the clinical presenta tion in the elderly patient, must be the foundation of preventive medical c are in geriatric gastroenterology.