Your Gut Feeling

As we age, it’s not uncommon to experience some type of gastrointestinal distress — symptoms such as abdominal pain, constipation and diarrhea. There are many reasons these symptoms may occur, from simply easting a food that disagrees with us to a much more serious issue, such as colorectal cancer. Medications may also cause gastrointestinal symptoms. Your healthcare provider and pharmacist can recommend lifestyle changes or over-the-counter treatment for bloating, constipation and diarrhea. But if these symptoms last longer than a day or two, it’s important to have your healthcare provider check them out. 

When these symptoms occur without another diagnosis, they are referred  to as Irritable Bowel Syndrome (IBS), which is estimated to affect 10 to 15 percent of adults in the United States and is more common in women and in people under the age of 45. 

While there is no cure for IBS, making changes to your diet such as eating smaller meals and ingesting more fiber — or taking fiber supplements — can help. Some people may need laxatives or antibiotics. Your provider can help you determine the best approach based upon your symptoms, once more serious conditions are ruled out. 

Serious conditions that can cause IBS-like symptoms as we age include diverticulitis, colorectal cancer as mentioned above, and peptic ulcers.

Diverticulitis
This condition — more common in older adults — occurs when pouches in the walls of the colon become inflamed or infected. Diverticulitis, which can be very painful, is characterized by pain in the left side, diarrhea or constipation, fever and chills, bloating, nausea and sometimes vomiting. 

The causes are unknown, but may be related to not having enough fiber in your diet. Taking in more fiber, using probiotics and taking antibiotics may be prescribed as treatment. Your provider may also recommend a clear liquid diet during flare-ups to allow the colon to heal until your condition improves. Serious cases may require surgery. 

The incidence of diverticulitis has been rising in recent decades, though it is difficult to measure because many patients are asymptomatic. Researchers estimate that 50 to 66 percent of people over the age of 80 have this condition, which is uncommon in those under the age of 40.

Colorectal Cancer
People over the age of 50 are at greater risk for colorectal cancer, but it is most frequently diagnosed among people ages 65 to 74. Colon/rectal cancer is the second leading cause of cancer death in the United States, with the highest percentage of deaths occurring among people ages 75 to 84. It accounts for roughly eight percent of all new cancer cases. Symptoms include blood in the stool, weight loss, abdominal or back pain, constipation and diarrhea.

Many people don’t have any symptoms in the early stages, so it’s important to get screened. The U.S. Preventive Services Task Force recommends screening using fecal occult blood testing, sigmoidoscopy or colonoscopy in adults ages 50 to 75. The American Cancer Society recommends that one of the following tests be given for people at average risk: a sigmoidoscopy every five years, a colonoscopy every ten years, a barium enema every five years or a virtual colonoscopy every five years.

Screening is not recommended for adults over the age of 75 who have previously had routine screenings, though it is considered for those who have never been screened. For those over the age of 85, no screening is recommended. However, as always, it’s important to discuss your personal health history with your provider when making a decision about whether and how often to undergo any type of medical testing. 

Peptic Ulcers
Peptic ulcers — open sores located in the stomach or upper small intestine — can also cause gastrointestinal distress symptoms, including stomach pain, heartburn, bloating, nausea and intolerance of fatty foods. 

The most common causes of peptic ulcers are bacteria called H. pylori, certain nonsteroidal anti-inflammatory (NSAID) pain relievers, and other medications that may be part of a treatment plan for patients with a blood clot, osteoporosis or depression and anxiety.

Your healthcare provider may recommend a treatment plan that could include antibiotics, antacids or acid blockers, stomach protectors and stopping NSAIDS and other drugs suspected to be the cause. Smoking, drinking alcohol, high stress and spicy foods can make an ulcer worse or harder to heal. 

If symptoms become severe, see your provider immediately. Dangerous symptoms that should be checked out include vomit with blood that might look red or black, dark red or tarry stools, changes in appetite and unexplained weight loss.