Oberer Gastrointestinaltrakt und Alter

Zusammenfassung

Im Zuge der demografischen Entwicklung gewinnen altersbedingte Funktionsstörungen des Gastrointestinaltrakts zunehmend an Bedeutung in der klinischen Praxis. Die Ursachen liegen entweder in einer altersbedingten Neurodegeneration des Verdauungstrakts an sich oder sind Folgen bzw. Begleiterscheinungen von im Alter verstärkt auftretenden Erkrankungen. Besonders häufig findet sich bei alten Menschen eine auf verschiedene Ursachen zurückzuführende Dysphagie, die zu Mangelernährung, Lebensqualitätseinbußen und erhöhter Sterblichkeit führen kann und daher bei entsprechenden Hinweisen unbedingt zu diagnostizieren ist. Motilitätsstörungen des Magens können dyspeptische Beschwerden und Reflux verursachen, während Magenentleerung und Magensäuresekretion im Alter nicht verändert sind bzw. letztere sogar erhöht sein kann. Auf mukosaler und neuroendokriner Ebene kommt es zu verschiedenen altersbedingten Veränderungen, Dünndarmmotilität, -permeabilität und Nahrungsassimilation werden durch das Altern an sich jedoch nicht verändert. Klinisch relevante Funktionsstörungen und Beschwerden sind oftmals Folge von äußeren Einflüssen wie beispielsweise Medikamenten, die durch die Abnahme protektiver intrinsischer Faktoren nachteilige Effekte verursachen. Durch verschiedene Funktionsuntersuchungen sollte gerade bei alten Menschen konsequent nach Ursachen für Beschwerden gesucht werden, um Mangelernährung und somit eine Verschlechterung des Allgemeinzustands zu verhindern.

Abstract

In the course of the demographical trend age related functional disorders of the gastrointestinal tract are becoming more and more important in clinical practice. Causes are either age related neurodegenerations in the intestinal tract per se or are consequences or accessory symptoms of age related diseases. A frequent disorder in old patients is dysphagia – due to several causes – which can lead to malnutrition, loss of quality of life and increasing mortality. Therefore, dysphagia has to be diagnosed necessarily in case of relevant indications. Motility dysfunctions of the stomach can lead to dyspeptic discomfort and reflux while emptying of stomach and secretion of gastric acid are not influenced by age or the last can be increased, respectively. On mucosal and neuroendocrine level there are several age related modifications; however, motility of the small intestine, permeability and nutrient assimilation are not changed because of aging per se. Clinical relevant functional disorders and symptoms are often results of external factors like for example pharmaceuticals which can provoke adverse effects because of decreasing protective intrinsic parameters. Especially in old patients several functional tests should be conducted consequently to find out the causes of symptoms and thereby prevent malnutrition and decline in general condition.

Schlüsselwörter

altersbedingte Funktionsstörungen - Neurodegeneration - Dysphagie - pathologisches Altern

Keywords

age related functional disorders - neurodegeneration - dysphagia - pathologic aging

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