To most of us, the term “digestive system” indicates our stomach, but that’s only partially true.

"Broadly speaking, our digestive system refers to a group of organs, starting from the mouth, all the way through our stomach, small and large intestine, before ending at the anus. These organs work together to break down the food we consume, allowing our body to absorb important nutrients, and eliminate waste," explained Dr Wong Ann Mei, Associate Consultant from Sengkang Community Hospital’s (part of SingHealth Community Hospitals) Post-Acute & Continuing Care Department. SingHealth Community Hospitals is a member of the SingHealth group.

"From newfound food sensitivities to slower digestion, we may experience more digestive discomforts as we age. Starting from the mouth, having less saliva and decreased force from jaw muscles make it difficult to chew or swallow. From the esophagus to intestines, the muscles will become stiffer, weaker, and less efficient with age, while the tissues are also more likely to become damaged because new cells aren't forming as quickly as they once did. Similarly, our rectum enlarges with age and constipation becomes more common.

Additionally, other factors such as having a less active lifestyle, lower levels of sensory perception (taste, smell and sight), dental issues and discomfort as we grow old can further affect our ability to digest food," Dr Wong added.

4 Ways you can protect your digestive health with age 

1. Maintain a healthy diet

Add fibre to meals by including raw vegetables, fruits and whole grains. Eat a variety of these wholegrain food, especially brightly coloured produce, as they are richer in antioxidant. Boost calcium intake by consuming ikan bilis, mashed sardines, and tofu.

2. Consume less salt and foods with trans-fat

Such foods will lead to unwanted water retention and chronic diseases. 

3. Take care of your teeth

This is important as we rely on our teeth to chew our food well for it to be broken down into small enough pieces to be absorbed by your body. See a dentist if chewing is a problem.

4. Seek help if you are experiencing problems with eating, digestion, or oral health 

Prompt medical attention can make a difference between continued discomfort and poor health and a quality life filled with meaningful activity, wonderful memories, and continued enjoyment of food.

Early signs of digestive issues to look out for

1. Indigestion: A sensation of satiety and bloating, so much so that your entire meal feels ‘stuck’ inside. 

2. Constipation: A reduction in the frequency of bowel motion causing difficulty in passing stools. At times, the stools maybe hard and dry, leading to straining, abdominal pain, and poor appetite. 

3. Diarrhoea: Occurs when the digestive tract pushes matter through it too quickly. This means that there is an increased fluid, volume, and frequency of bowel movements. Abdominal discomfort is also quite common. 

4. Dysphagia: Difficulty swallowing (dysphagia) is common in older individuals. Symptoms include recurrent upper abdominal pain, nausea, belching, bloating, and indigestion.

3 Common gastrointestinal diseases faced in old age

1. Gastro-oesophageal Reflux Disease

Gastro-oesophageal reflux disease (GERD) occurs when the upper portion of the digestive tract is not functioning properly, causing stomach acid to flow back up into the esophagus. 

The most common symptom of GERD is acid reflux, while other symptoms include heartburn, acid or food regurgitation, persistent sore throat, chronic coughing, chest pain, and bad breath. Obesity and certain medications, including some blood pressure medications, which many older adults take, can cause heartburn. 

2. Diverticular Disease

About half of people age 60 and older have diverticular disease (also known as diverticulosis). This occurs when small pouches in the lining of the colon bulge out along weak spots in the intestinal wall. 

While many people with diverticulosis experience no symptoms, the pouches may occasionally become infected. If the pockets become inflamed, it's called diverticulitis, which can cause abdominal pain, fever, chills, nausea, and vomiting.

3. Polyps

After age 50, the risk increases for developing polyps, or small growths, in the colon. Polyps may be noncancerous or cancerous in nature. Majority of the polyps are asymptomatic, which is why screening colonoscopies are recommended for anyone over the age of 50. 

During this procedure, polyps can be removed before they become cancer. People with a family history of colorectal cancer (colon cancer) or other risk factors are recommended to go for their screenings earlier.

Simple home remedies for mild gastric discomfort

Mild gastric discomfort may be due to gas trapped in the intestines, causing cramps, bloating and even sharp pains. Most of us pass gas between 10 to 20 times a day on average, knowingly or unknowingly. When there is gas building up in our intestines, it will cause gastric discomfort. 

Here are simple home remedies that you may try to help release trapped gas: 

1. Always let it out! Resisting the urge to fart or consciously holding it in can cause bloating and discomfort. 

2. Get active. By simply walking around or exercising, it will help you to expel the gas. 

3. You should also ensure adequate hydration and take the recommended servings of fruits and vegetations for regular and healthy bowel movement. Passing stools will usually release any gas trapped in the intestines.

4. Finally, quit smoking and reduce consumption of carbonated drinks such as sodas which causes excessive air to enter the digestive tract causing bloating and pain. 

The above measures are simple home remedies will help to alleviate your gastric symptoms. However, if you are experiencing these symptoms frequently or persistently, it will be best to consult a doctor for a review as you may have a health condition which requires treatment.

When to seek medical attention immediately

There are some symptoms which you should never brush off. Doctors call them “red-flag” symptoms as they need immediate medical attention. When it comes to the digestive system, "red-flags" include:

1. Blood in stools

Bright red blood in your stool maybe due to piles (also known as hemorrhoids) or a small tear in around the anus known as anal fissure. However, other causes such as an autoimmune condition or a malignant growth can cause it and you should always mention this to your doctor.

2. Significant change in bowel habits 

If you find yourself having alternating or persistent diarrhoea and constipation which hasn’t happened in the past, you should see a doctor. 

3. Persistent difficulty swallowing

If you have a persistent sensation of food being stuck at your chest, this is a sign of alarm. 

4. Unexplained weight loss 

While this is not exactly a gut symptom, this should always be investigated. 

The above list is not comprehensive, but these are the common “red-flags” which should always be reviewed by your doctor. If you are unsure whether a symptom is a cause of concern, always consult a doctor to be on the safe side.

Ref: I23

Check out related articles:

Gastric Pain: Common Causes, How to Prevent and Treat

10 Easy Ways to a Healthier Liver

7 Tips to Reduce Belching or Burping

Irritable Bowel Syndrome (IBS): What to Eat and Avoid

Piles (Haemorrhoids): How to Prevent and Treat