[Progress in the treatment of gastroenterologic diseases in advanced age]

Therapeutic advances in gastroenterology benefit patients of all ages, although the elderly ones receive more benefits than others. The latter is especially true for operative endoscopy where, in some cases, otherwise high-risk patients can be spared an operation. Peptic stenosis, which is common in elderly patients as a result of reflux oesophagitis, can be treated by bougienage. Bleeding from gastric and duodenal ulcers can cause problems in the elderly. In most cases endoscopic treatment by electro- or laser coagulation, or by sclerotherapy can avoid the need for surgery, or at least the conversion of an emergency operation into an elective one with a better prognosis is possible. Adenomata in the colon are common causes of chronic blood loss and can become malignant. They should be removed endoscopically. Another typical age-dependent finding, which can be treated by electro- or laser coagulation in the colon are angiodysplasia, which can be the origin of massive haemorrhage. It is now becoming accepted that in an elderly patient, stones in the common bile duct should be managed by endoscopic sphincterotomy and gallstone removal. This approach is safer and quicker than conventional surgery. The practice of endoscopic drainage by insertion of a prosthesis in cases of malignant obstructive jaundice is although increasing in older patients.