The digestive system is a complex network of organs working together to break down food, absorb nutrients, and eliminate waste. From the mouth to the anus , each organ plays a crucial role in transforming what we eat into fuel for our bodies.
As we age, our digestive system undergoes changes that can impact nutrient absorption and overall health. Understanding these changes is vital for maintaining proper nutrition and preventing digestive disorders in older adults .
Digestive System Anatomy and Physiology
Roles of digestive organs
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Mouth
Mechanical digestion : chewing food into smaller pieces increases surface area for enzymatic action
Chemical digestion: salivary amylase begins breakdown of carbohydrates (starch) into simpler sugars
Esophagus
Peristalsis : rhythmic muscular contractions propel food from the mouth to the stomach (bolus )
Stomach
Mechanical digestion: churning and mixing food with gastric secretions forms chyme
Chemical digestion: pepsin and hydrochloric acid break down proteins into peptides
Small intestine
Duodenum : receives chyme from the stomach and secretions from the pancreas (enzymes) and liver (bile )
Jejunum and ileum : majority of nutrient absorption occurs through villi and microvilli
Brush border enzymes : complete digestion of carbohydrates (maltase , sucrase , lactase ) and proteins (peptidases )
Pancreas
Exocrine function: secretes digestive enzymes (lipase , amylase , trypsin ) into the duodenum
Endocrine function: releases insulin and glucagon to regulate blood sugar levels
Liver
Produces bile: emulsifies fats into smaller droplets (micelles ) for easier digestion by lipase
Metabolic functions: nutrient processing, storage (glycogen , vitamins), and detoxification
Gallbladder
Stores and concentrates bile from the liver
Releases bile into the duodenum when stimulated by cholecystokinin (CCK) in response to fat
Large intestine
Absorption of water and electrolytes (sodium, potassium) to form solid feces
Fermentation of undigested fibers by gut bacteria produces short-chain fatty acids (butyrate )
Formation and storage of feces in the descending colon, sigmoid colon, and rectum
Rectum and anus
Storage and elimination of feces through defecation reflex triggered by rectal distension
Digestive System Functions and Regulation
Digestion: breakdown of food into smaller molecules for absorption
Absorption: uptake of nutrients from the digestive tract into the bloodstream
Secretion : release of enzymes, acids, and other substances to aid in digestion
Motility : movement of food through the digestive tract (e.g., peristalsis )
Enteric nervous system : network of neurons in the gut wall that regulates digestive functions
Gastrointestinal hormones : chemical messengers that coordinate digestive processes
Microbiome : community of microorganisms in the gut that contribute to digestion and overall health
Common digestive disorders
Gastroesophageal reflux disease (GERD)
Weakened lower esophageal sphincter allows stomach acid to reflux into the esophagus
Causes heartburn, chest pain, and potential esophageal damage (erosions, strictures, Barrett's esophagus)
Peptic ulcers
Erosion of the stomach (gastric ulcer) or duodenal lining (duodenal ulcer) due to H. pylori infection or NSAIDs
Leads to abdominal pain , bleeding, and potential perforation or obstruction
Inflammatory bowel disease (IBD)
Crohn's disease : chronic inflammation throughout the GI tract, most commonly in the ileum and colon
Ulcerative colitis : chronic inflammation limited to the colon and rectum
Both cause diarrhea, abdominal pain, malnutrition, and increased risk of colorectal cancer
Celiac disease
Autoimmune disorder triggered by gluten consumption in genetically susceptible individuals
Damages the small intestinal villi, leading to malabsorption and nutrient deficiencies (iron , calcium , vitamin D)
Diverticulosis and diverticulitis
Diverticulosis: formation of pouches (diverticula) in the colon wall, often asymptomatic
Diverticulitis: inflammation and infection of diverticula causing abdominal pain, fever, and potential complications (perforation, abscess, fistula)
Aging and digestive function
Oral health
Tooth loss and periodontal disease can impair chewing and food intake, leading to nutritional deficiencies
Decreased salivary flow (xerostomia ) affects taste, chewing, and swallowing , increasing risk of dental caries and infections
Esophageal changes
Weakened peristalsis and lower esophageal sphincter can lead to dysphagia (difficulty swallowing) and GERD
Gastric changes
Decreased gastric acid secretion (hypochlorhydria ) impairs vitamin B12 absorption, increasing risk of pernicious anemia
Delayed gastric emptying can cause early satiety and reduced appetite , contributing to unintentional weight loss
Intestinal changes
Reduced intestinal motility can lead to constipation and fecal impaction
Decreased brush border enzyme activity and absorptive surface area may impair nutrient absorption (calcium, vitamin D, B vitamins)
Pancreatic and hepatic changes
Reduced pancreatic enzyme secretion can affect digestion of fats, proteins, and carbohydrates
Decreased hepatic function may impair nutrient metabolism , drug clearance, and increase susceptibility to drug-nutrient interactions
Microbiome alterations
Changes in gut bacteria composition (dysbiosis ) may influence nutrient absorption, immune function, and risk of infections (C. difficile )
Polypharmacy
Multiple medications can interact with nutrients (calcium, iron, vitamin D) and affect digestive function (constipation, diarrhea, nausea)
Psychosocial factors
Social isolation, depression, and cognitive decline can impact dietary intake, food choices, and overall nutritional status