Aging brings many surprises, from creaky joints to hangovers after just a few sips of beer. However, one of the most frustrating changes is how our digestive system becomes less efficient. "Intestinal issues can arise at any age and become more prevalent as we age," says Dr. Sara Attalla, a gastroenterologist at Inspira Health in New Jersey.
According to the National Institutes of Health, roughly 60 to 70 million Americans suffer from digestive diseases. Common symptoms include heartburn, bloating, abdominal pain, and changes in bowel habits such as constipation, diarrhea, or both. Pinpointing the cause can be challenging due to a combination of aging and lifestyle factors.
How Aging Affects Digestion
As we age, the nerves and muscles in the gastrointestinal (GI) tract may malfunction, leading to slower digestion and disrupted communication between digestive organs. For instance, movement in the esophagus and swallowing muscles may become less coordinated, increasing the risk of gastroesophageal reflux disease (GERD). Slower stomach motility can cause food to linger, triggering indigestion.
"The stomach lining can become thinner with age, making you more susceptible to inflammation and injury," Attalla explains. Decreased production of prostaglandins, which help protect the stomach lining, also raises the risk of gastritis and ulcers.
In the small bowel, slower motility can lead to bacterial overgrowth, causing bloating and diarrhea, according to Dr. Sunana Sohi, a gastroenterologist in Louisville, Kentucky. Colon motility issues may result in constipation and diverticulosis, where small sacs form in the colon wall.
Chronic health conditions like arthritis and cardiovascular disease can limit physical activity, further slowing gut motility. "If you don't move, neither does your gut," says Dr. Pritesh Mutha, an associate professor at UTHealth Houston. Medications for these conditions, especially NSAIDs, often cause gastrointestinal side effects like nausea, constipation, and ulcers.
Tips to Optimize Digestion as You Age
Chew Thoroughly
Digestion begins in the mouth. Salivary enzymes break down starches and fats, reducing the GI tract's workload. Chewing food into smaller pieces and aiming for 15 to 20 chews per bite can also help with swallowing difficulties.
Stimulate Saliva Production
Saliva production decreases with age, affecting chewing and swallowing. Dry mouth is twice as common in those taking daily medications. Using over-the-counter saliva substitutes or sipping water between bites can help.
Eat a Plant-Based, Low-Processed Diet
A diet rich in plant-based foods and low in processed items supports a healthy gut microbiome. "Diets high in processed food can alter the gut microbiome, leading to dysbiosis," Sohi warns. Increasing fiber intake—both soluble and insoluble—bulks up stool, preventing constipation and diarrhea.
Stay Hydrated
Hydration is essential to avoid constipation, especially when increasing fiber. The National Council on Aging recommends drinking one-third of your body weight in fluid ounces daily. For a 150-pound person, that's 50 ounces (about 6.25 cups) of water per day.
Exercise Regularly
"Exercise stimulates GI tract motility," Sohi says. Avoid lying down after eating, as it can promote acid reflux. Instead, take a 15-minute walk after meals to improve gastric emptying.
Get Enough Sleep
Sleep is vital for healing. Poor sleep can adversely affect the gut barrier and immunity, potentially causing gastrointestinal symptoms. Aim for seven to nine hours per night.
Manage Medications
"Any and every medicine has GI side effects," Mutha notes. Take medications as prescribed—NSAIDs with food, acid suppressants 30 minutes before breakfast—and consult your doctor if side effects occur.
When to See a Doctor
Even if you suspect age-related issues, don't assume. "Share your symptoms with your doctor, as there could be a more serious underlying cause," advises Dr. Neena Mohan, a gastroenterologist at Temple University. Seek medical attention if you experience persistent changes in bowel habits, trouble swallowing, abdominal pain, unexplained weight loss, or blood in your stool. Your doctor may recommend bloodwork, medications, or procedures like endoscopy or colonoscopy.
