Aging of enteric neuromuscular systems in gastrointestinal tract

Abstract

Background Aging is a complex biological process and associated with a progressive decline in functions of most organs including the gastrointestinal (GI) tract. Age‐related GI motor disorders/dysfunctions include esophageal reflux, dysphagia, constipation, fecal incontinence, reduced compliance, and accommodation. Although the incidence and severity of these diseases and conditions increase with age, they are often underestimated due in part to nonspecific and variable symptoms and lack of sufficient medical attention. They negatively affect quality of life and predispose the elderly to other diseases, sarcopenia, and frailty. The mechanisms underlying aging‐associated GI dysfunctions remain unclear, and there is limited data examining the effect of aging on GI motor functions. Many studies on aging‐associated changes to cells within the tunica muscularis including enteric neurons, smooth muscles, and interstitial cells have proposed that cell loss and/or molecular changes may be involved in the pathogenesis of age‐related GI motor disorders/dysfunctions. There is also evidence that the aging contributes to phenotypic changes in innate immune cells, which are physically and functionally linked to other cells in the tunica muscularis and can alter GI (patho) physiology. However, various patterns of changes have been reported, some of which are contradictory, indicating a need for additional work in this area. Purpose Although GI infection due to intestinal bacterial overgrowth, bleeding, and cancers are also important and common problems in the elderly patients, this mini‐review focuses on data obtained from enteric neuromuscular aging research with the goal of better understanding the cellular and molecular mechanisms of enteric neuromuscular aging to enhance future therapy.

The Crucial Role of the Interstitial Cells of Cajal in Neurointestinal Diseases

“…As individuals age, numerous changes occur in the nervous and GI tract, which can have an impact on the normal functioning of the digestive system [ 10 , 11 ]. Elderly individuals commonly experience various GI problems, including decreased intestinal motility, reduced gastric compliance and accommodation, impaired swallowing, and a weakened lower esophageal sphincter (LES) [ 10 , 11 ]. These age-related alterations in GI motility can lead to symptoms such as indigestion, constipation, diarrhea, and abdominal discomfort [ 10 , 11 ].…”

“…Elderly individuals commonly experience various GI problems, including decreased intestinal motility, reduced gastric compliance and accommodation, impaired swallowing, and a weakened lower esophageal sphincter (LES) [ 10 , 11 ]. These age-related alterations in GI motility can lead to symptoms such as indigestion, constipation, diarrhea, and abdominal discomfort [ 10 , 11 ]. These dysfunctions have been associated with early satiety, heightened satiation, and a decline in body weight [ 12 ].…”

“…These dysfunctions have been associated with early satiety, heightened satiation, and a decline in body weight [ 12 ]. Despite being underestimated due to a lack of awareness, overlapping symptoms, diagnostic challenges, and complex mechanisms, these age-associated GI motor dysfunctions significantly affect the individual’s quality of life and increase their vulnerability to conditions such as protein or energy malnutrition, sarcopenia, and frailty [ 10 , 13 ]. Notably, studies have established a correlation between reduced food intake and increased overall mortality rates in both elderly individuals and aged mice [ 14 , 15 ].…”

Efficacy and safety of Buzhongyiqi decoction combined with acupoint application for functional constipation in elderly people: A systematic review and meta-analysis

“…[6] Decline in body function and weakening of gastrointestinal power are significant causes of constipation in elderly people. [7] CM diagnosis in elderly patients with constipation mostly belongs to the pattern of spleen and stomach qi deficiencies. [8] Buzhongyiqi decoction tonifies the spleen and stomach, elevates the Yang qi and promotes the movement of the intestinal tract.…”

Case analysis of effective interventions for chronic constipation in older adult patients with dementia

“…3 Therefore, constipation can be challenging to manage and treat effectively, and leads to a significant decline in quality of life and appetite, due to abdominal distension in older individuals. 4 To address the issue of chronic constipation in older patients, a multidisciplinary healthcare team was established in 2022, comprising physicians, nurses, physiotherapists and occupational therapists. The team aimed to intervene in patients with intractable constipation, and to provide appropriate treatment based on objective evaluation of the stool volume and consistency in the rectum, using ultrasonography.…”