Functional Bowel Disease
Functional bowel disorders refer to disorders of gut-brain interaction that affect the intestinal tract. Irritable bowel syndrome (IBS) is the most common functional bowel disorder and affects individuals regardless of age and gender. It can result in impaired quality of life and significant health care utilization and is therefore important to recognize and manage. The diagnosis of IBS is based on clinical symptoms. IBS is categorized based on predominant bowel habit (constipation, diarrhea, mixed, or unclassified), and the treatment of IBS is individually tailored based on subtype and symptom severity. (Source: Clinics i...
Source: Clinics in Geriatric Medicine - October 31, 2020 Category: Geriatrics Authors: Aiya Aboubakr, Michelle S. Cohen Source Type: research
Colorectal Cancer Screening in the Elderly
Colorectal cancer (CRC) is a common and preventable malignancy, and routine CRC screening is recommended for average risk individuals between the ages of 50 and 75 years. Screening has been shown to decrease CRC incidence and mortality. Once patients are older than 75 years, the risk to benefit ratio of ongoing screening begins to shift. As comorbidities increase and life expectancy decreases, the future potential benefits of CRC prevention become less robust, and risk for screening-related complications grows. However, firm age cutoffs are not sufficient to guide these decisions, as there is substantial physiologic hetero...
Source: Clinics in Geriatric Medicine - October 31, 2020 Category: Geriatrics Authors: Andrea L. Betesh, Felice H. Schnoll-Sussman Source Type: research
Inflammatory Bowel Disease in the Older Adult
Although management of inflammatory bowel disease follows a similar approach for all adults, there are certain characteristics making its treatment more challenging in older patients. The advent of novel medical treatments has changed the paradigm of inflammatory bowel disease, with an increasing focus on preventing disease progression in addition to controlling symptoms. The safety of these therapies in the elderly needs to be considered. Management of inflammatory bowel disease in the elderly is confounded by comorbidities that can increase the risk of medication or surgical complications; polypharmacy and altered pharma...
Source: Clinics in Geriatric Medicine - October 31, 2020 Category: Geriatrics Authors: Shirley Cohen-Mekelburg, Akbar K. Waljee Source Type: research
Common Gastroenterology Disorders in the Elderly
We are not victims of aging, sickness, and death. These are part of scenery, not the seer, who is immune to any form of change. This seer is the spirit, the expression of eternal being. —Deepak ChopraThe world is aging. With improved access to nutrition, hygiene, vaccinations, preventative care, and medical care for chronic diseases, the global average age continues to rise as does the number of elderly patients. The United Nations estimates approximately 1 in 10 people in the wo rld are over the age of 65 and expects this figure to climb. (Source: Clinics in Geriatric Medicine)
Source: Clinics in Geriatric Medicine - October 31, 2020 Category: Geriatrics Authors: Amir Soumekh, Philip O. Katz Tags: Preface Source Type: research
Esophageal and Gastric Motility Disorders in the Elderly
The elderly are particularly prone to developing upper gastrointestinal disturbances. Changes are due to the aging process, diabetes, cardiovascular risk factors, and neurologic issues. Medications used to treat these underlying conditions can cause gastrointestinal symptoms. Dysphagia is common and can be oropharyngeal and/or esophageal. Gastroparesis is due to either medications such opiates, or due to neurologic sequala of diabetes, cerebrovascular accidents, or neurologic diseases such as Parkinson ’s disease. Given limitations in many commonly used prokinetics with a wide range of side effect profiles including neur...
Source: Clinics in Geriatric Medicine - October 29, 2020 Category: Geriatrics Authors: Morgan A. Sendzischew Shane, Baharak Moshiree Source Type: research
Gastroesophageal Reflux Disease and Barrett Esophagus in the Elderly
As our population continues to age, the early diagnosis and optimal management of patients with gastroesophageal reflux disease becomes paramount. Maintaining a low threshold for evaluating atypical symptoms in this population is key to improving outcomes. Should patients develop complications including severe esophagitis, peptic stricture, or Barrett esophagus, then a discussion of medical, endoscopic, and surgical treatments that accounts for patient ’s comorbidities and survival is important. Advances in screening, surveillance, and endoscopic treatment of Barrett esophagus have allowed us to dispel concerns of futili...
Source: Clinics in Geriatric Medicine - October 29, 2020 Category: Geriatrics Authors: Fouad Otaki, Prasad G. Iyer Source Type: research
Managing Gallstone Disease in the Elderly
Geriatric patients tend to have subtle presentations of biliary disorders and, if untreated, can decompensate acutely. Each biliary disorder warrants formulation of an individualized treatment plan with a multidisciplinary approach. Acute cholecystitis, a common complication of gallstones, is initially managed by conservative measures and subsequently, among patients with optimal surgical risk, through laparoscopic or open cholecystectomy. High-risk patients undergo temporization, percutaneous or endoscopic, followed by definitive intervention. Acute cholecystitis with complications (ie, perforation, gangrene, or small bow...
Source: Clinics in Geriatric Medicine - October 29, 2020 Category: Geriatrics Authors: Ankit Chhoda, Saurabh S. Mukewar, SriHari Mahadev Source Type: research
Fecal Incontinence in the Elderly
Fecal incontinence can be a challenging and stigmatizing disease with a high prevalence in the elderly population. Despite effective treatment options, most patients do not receive care. Clues in the history and physical examination can assist the provider in establishing the diagnosis. Direct inquiry about the presence of incontinence is key. Bowel disturbances are common triggers for symptoms and represent some of the easiest treatment targets. We review the epidemiology and impact of the disease, delineate a diagnostic and treatment approach for primary care physicians to identify patients with suspected fecal incontine...
Source: Clinics in Geriatric Medicine - October 29, 2020 Category: Geriatrics Authors: Trisha Pasricha, Kyle Staller Source Type: research
Healthy Aging
CLINICS IN GERIATRIC MEDICINE (Source: Clinics in Geriatric Medicine)
Source: Clinics in Geriatric Medicine - October 1, 2020 Category: Geriatrics Authors: Susan M. Friedman Source Type: research
Copyright
ELSEVIER (Source: Clinics in Geriatric Medicine)
Source: Clinics in Geriatric Medicine - October 1, 2020 Category: Geriatrics Source Type: research
Contributors
SUSAN M. FRIEDMAN, MD, MPH, AGSF (Source: Clinics in Geriatric Medicine)
Source: Clinics in Geriatric Medicine - October 1, 2020 Category: Geriatrics Source Type: research
Contents
Susan M. Friedman (Source: Clinics in Geriatric Medicine)
Source: Clinics in Geriatric Medicine - October 1, 2020 Category: Geriatrics Source Type: research
Forthcoming Issues
Gastroenterology (Source: Clinics in Geriatric Medicine)
Source: Clinics in Geriatric Medicine - October 1, 2020 Category: Geriatrics Source Type: research
Reducing Frailty to Promote Healthy Aging
Frailty is a complex geriatric syndrome. Frail patients typically present with an array of multiple complex symptoms and significantly reduced tolerance for medical and surgical interventions. A multidomain approach is required to effectively treat/manage frailty. (Source: Clinics in Geriatric Medicine)
Source: Clinics in Geriatric Medicine - August 31, 2020 Category: Geriatrics Authors: Veronica C. Nwagwu, Christine Cigolle, Theodore Suh Source Type: research
Healthy Aging Across the Stages of Old Age
Healthy aging is among the key frontiers for twenty-first century geriatrics and gerontology. Gerontology is positioned to address not only disease, debility, frailty, and death but also patients' hopes to remain healthy and high functioning and optimize their wellness. Definitions, models, and metrics of healthy aging are increasingly dynamic and multidimensional, drawing from biomedicine, social sciences, older adults ’ perspectives, and geroscience. Given current and projected demographics, focus on healthy aging at population, health system, research, clinical, and individual levels will lower costs and burdens while...
Source: Clinics in Geriatric Medicine - August 28, 2020 Category: Geriatrics Authors: Louise Aronson Source Type: research
