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Intestinal malabsorption in the elderly.

Peter R Holt1

  • 1Strang Cancer Research Laboratory, Rockefeller University, New York, NY 10021, USA. holtp@rockefeller.edu

Digestive Diseases (Basel, Switzerland)
|May 1, 2007
PubMed
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Malabsorption in the elderly is often overlooked due to subtle symptoms. Early diagnosis and management, especially for conditions like celiac disease, are crucial for better health outcomes in older adults.

Area of Science:

  • Gastroenterology
  • Geriatrics
  • Internal Medicine

Background:

  • Intestinal malabsorption is uncommon in the elderly, with subtle clinical signs often delaying diagnosis.
  • Aging affects calcium, zinc, and magnesium absorption; achlorhydria can impair vitamin B12, folic acid, and calcium uptake.

Purpose of the Study:

  • To discuss the evaluation and management of intestinal malabsorption in the elderly population.
  • To highlight common causes and diagnostic challenges of malabsorption in older adults.

Main Methods:

  • Review of physiological changes with aging impacting nutrient absorption.
  • Discussion of conditions like small bowel bacterial overgrowth and celiac disease in the elderly.
  • Emphasis on diagnostic approaches including serologic tests and small intestinal biopsy.

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Main Results:

  • Small bowel bacterial overgrowth is more prevalent in the elderly.
  • Pancreatic insufficiency can occur in older patients without a clear cause.
  • Celiac disease is common in all ages, often presenting later in life with occult manifestations.

Conclusions:

  • Elderly patients with celiac disease may face challenges with gluten-free diets, requiring intensive nutritional support.
  • A pragmatic approach is essential for evaluating malabsorption in older individuals.
  • Recognizing atypical presentations of conditions like celiac disease is key for timely intervention.