5. DETERMINE (13–15)
6.6 CONCLUSION
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120 Johnson
7 Common Gastrointestinal Complaints in Older Adults
Stephen A. McClave
Key Points
! Medication effects and specific dietary factors, such as acid and foods lowering esophageal sphincter pressure, require special attention in older adults with esopha- geal and gastric disorders.
! The high prevalence of atrophic gastritis in older adults increases the risk for vitamin B12malabsorption and deficiency.
! Evaluation of both diarrhea and constipation requires a thorough history (paying attention to diet, activities, and bowel habits) and a careful physical examination (including a digital rectal exam).
! Hepatitis is more common among older adults than originally appreciated and is often secondary to medications or hepatitis C exposure.
! Evaluation of anemia in older adults should include assessment of iron stores, copper, zinc, B12, and folate levels.
Key Words: Esophageal function; atrophic gastritis; dysphagia; diarrhea;
constipation; anemia; hepatitis; gut