“Listen to your gut” has always been sound advice when it comes to making decisions. But it’s also smart to take that advice literally — to pay attention to the physical signals your GI system sends you, especially as you get older.
Research suggests that as you age, you’re at a greater risk for a range of digestive issues and conditions. Not only can they cause discomfort, they can have a ripple effect and hugely impact your health overall.
For example, your gut is home to about 70 percent of your immune system in the form of microbes that send and receive signals from all corners of your body. Your gut also acts as a barrier, protecting your blood and tissues from pathogens or potentially damaging microorganisms. Plus, your stomach and intestines are ground zero for breaking down and delivering essential nutrients that fuel and nourish every part of you.
As you get older, your GI system ages just like your knees, eyesight and other body parts. Some of the aging and subsequent issues are due to internal factors you can’t control, says Dr. Bill Rawls, M.D., Medical Director of Vital Plan.
“Our mitochondria burn out over time, which causes cells to age and die off,” Dr. Rawls says. “Your new cells are only as good and healthy as the mitochondrial and nuclear DNA blueprint used to create them. So the cells of 20 year old are going to be very different than that of an 80 year old.”
But external lifestyle factors such as diet, stress, physical activity, toxins, and more also affect cells and mitochondria, and contribute significantly to aging. That’s why among 80-year-olds, some get sicker and seem “older” than others.
The good news is that these age-advancing external factors are completely under your control, and taking steps to address them now can help you prevent GI issues later. Even if you’re already experiencing certain digestive complications that come on with age, you can likely reduce or even reverse some of the problems. “I’m constantly amazed at what the human body can do,” Dr. Rawls says.
6 Gut Issues to Watch Out For
Here’s an overview of the GI issues that tend to be more common as you get older, followed by the best strategies to prevent or address them to ensure a smooth functioning gut at any age.
1. Leaky Gut
Older people are much more likely to develop gaps in the lining of their intestines, which is commonly known as leaky gut syndrome. Those microscopic openings offer a way in for pathogenic or harmful compounds and organisms to enter our systems, which can lead to symptoms such as food sensitivities, diarrhea, bloating, brain fog, fatigue, chronic inflammation, and more.
While experts aren’t exactly sure why leaky gut occurs, research suggests it may have to do with aging epithelial cells that line the intestines. But there are likely several other factors at play, too, such as a poor diet, stress and toxins, Dr. Rawls says. Other research suggests disruption of the beneficial microbes that line the gut could also contribute.
2. Heartburn (a.k.a. Acid Reflux)
That burning sensation that’s the hallmark of heartburn is caused when stomach acid seeps up into the esophagus and irritates its delicate lining. Although anyone can get heartburn at any age (and it’s often brought on by food), it tends to be more common and chronic as people get older.
One explanation is that the muscle that helps the esophageal sphincter stay contracted — what keeps stomach acid out of the esophagus — naturally weakens with age. Persistent reflux, especially as you get older, however, is likely more the result of a history of eating unhealthy, processed food, Dr. Rawls says.
“There’s very little water in the foods that make up a typical Western diet, which is loaded with processed carbs and meat, so people wash it down with a 20-ounce ice-cold drink,” he explains. “Drinking cold liquid dilutes your stomach acid, stopping the digestion process so the food sits there just stewing.”
At the same time, the pH of your stomach acid rises, which sends a signal to the sphincter to relax, allowing acid to enter the esophagus. Though higher-pH acid is actually less acidic, it’s still harsh enough to burn the esophagus. (Normal digestion causes pH of your stomach acid to bottom out, and it’s that superacidic signal that signals the sphincter to clamp tightly shut, Dr. Rawls says.) Over time, a consistently dysfunctional digestion process may lead to chronic reflux.
While young people can experience constipation, chronic or “functional” constipation is more common in those older than 64, according to a paper in the Canadian Journal of Gastroenterology. It reports that, among older adults, the prevalence rate of chronic constipation is between 12.5% and 30%.
There are likely a few reasons. For one, as you get older, your stomach may naturally produce less acid as part of the aging process, Dr. Rawls says. But years of chowing down on mostly unhealthy, processed foods (and washing it down with copious amounts of cold liquid) can make the problem worse, he adds. If you’re not producing enough stomach acid, you’re not breaking down food as efficiently — which is the first step in healthy digestion and regular bowel movements.
Many older adults’ diets also lack fiber from fresh fruits and vegetables, which helps form easy-to-pass stools. Instead, waste becomes hard and slow moving. In addition, the muscle contractions that help move food and waste through the GI system can become sluggish with age. And as people get older, they’re also less likely to be physically active, another factor that can help maintain regular bowel movements.
This inflammatory condition starts out as diverticulosis — when sac-like pouches (called diverticulum) protrude from the colon. By age 60, about one-third of Americans develop these protrusions, often in areas of the colon where the muscle is weak or the colon is narrow.
Connective and muscle tissue naturally weaken with age, but a low-fiber diet also contributes because it makes stools hard and harder to pass, which increases pressure in the colon and the likelihood for protrusions. For example, men who ate a high-fiber diet were 42% less likely to develop the condition.
Although many cases of diverticulosis don’t cause symptoms, up to 20% of those will turn into diverticulitis, which tends to happen mostly to older adults. The acute infection and inflammation of diverticulum is caused by harmful bacteria from the colon getting stuck. Along with stomach pain, other symptoms include fever and digestive problems.
While ulcers can develop any time, studies suggest these breaks in or sores on the lining of the stomach or upper part of the small intestine (the duodenum) may be more common in older adults. One study, for example, found that the mean age of those with gastric ulcers was 66, while duodenal ulcer patients’ mean age was 57. Meanwhile, those over 65 are more likely to be hospitalized for ulcers, according to a study in the journal Emerging Infectious Diseases.
Ulcers, which can cause a burning pain in the stomach when acid seeps through the lining’s wound, are often due to the bacteria Helicobacter pylori. About 50% of people worldwide have H. pylori bacteria in their systems, and it seems to be more common the older you get. While the bacteria doesn’t cause symptoms in all people, in some — and particularly older adults — it sets off an inflammatory response that produces the wound in the stomach’s lining.
Frequent and long-term use of pain relievers, including ibuprofen and other NSAIDs and aspirin, can also trigger ulcers. This is another possible reason they’re more common in older adults, who tend to take NSAIDS more regularly for arthritis and other pain, and aspirin for pain or cardiovascular reasons. Stress can also make symptoms worse.
6. Gut Dysbiosis
When it comes to bacteria in your gut, diversity is a sign of a healthy, balanced microbiome, Dr. Rawls says. But in the elderly, diversity and the composition of beneficial bacteria may be reduced, while opportunistic and pathogenic microbes increase, including C. difficile, a harmful bacteria that causes severe diarrhea, according to a paper in Nutrition and Healthy Aging. Other research found that the gut’s microbiota is less stable in older adults. The reasons why aren’t completely clear, but it’s likely due to changes in diet, physical activity and other lifestyle factors.
How to Protect Your Gut at Any Age
Regardless of the gut condition, the strategies for preventing or addressing it are generally the same.
1. Clean Up Your Diet
A healthy diet is one of the best ways to protect against leaky gut, Dr. Rawls says. Fiber is key here. Not only can fiber help relieve and protect you against constipation, it feeds the good bacteria in your gut. Do the following things, and you’ll easily get the recommended 25 to 30 grams of fiber each day from healthy whole-food sources:
- Make sure at least half of each meal consists of fiber-rich vegetables and fruit.
- Trade processed meat, grains, and fatty foods for fish, poultry, nuts, and other plant-based ingredients.
- Cut way back on or eliminate sugar.
- Avoid fiber supplements or fortified foods. Fiber from natural, plant-based foods is best.
Meanwhile, reducing your intake of fatty foods can help prevent and manage reflux. One recent study in the journal JAMA Otolaryngology, Head & Neck Surgery, for example, found that a Mediterranean diet was as effective at improving reflux than drugs that totally shut down the production of stomach acids. (Avoid antacid drugs, as they don’t treat the underlying problem, plus can cause a rebound effect when you discontinue use, Dr. Rawls says.)
2. Try an Apple Cider Vinegar Aperitif
Whether you struggle with acid reflux or other digestion problems, mix 2 tablespoons of apple cider vinegar with 6 ounces of water and drink it before every meal, Dr. Rawls suggests. “It adds to the acidity of your stomach acid, helping signal the esophageal sphincter to shut and to empty the stomach,” he says. “It’s one of the best things I’ve found to help people with chronic reflux.”
3. Stay Hydrated
Drinking enough water throughout the day and eating water-rich foods such as melon, cucumbers, spinach, peppers, strawberries, broccoli, and oranges can help with constipation and general digestion. Also, watch for signs that you may not be getting enough fluids.
4. Go for a Walk
Physical activity can help stimulate healthy digestion by keeping food and waste moving through your GI tract, and it keeps you healthy overall, Dr. Rawls says. Research from Harvard also finds that exercising regularly reduces risk of diverticulosis by 37%.
5. Eat More Bitters
Humans’ bitter taste receptors are a key part of the digestive process. They stimulate production of stomach acid and enzymes that help break down food and prime the GI tract for action. Yet most of today’s modern diet is sweet or bland — even some vegetables that once were bitter have been cultivated to taste more sweet, Dr. Rawls says.
You can take advantage of your gut’s 25 different bitter taste receptors and their digestive benefits with aromatic bitters (bitter herbal extracts in a base), and by taking supplements of bitter herbs. Three good ones to try:
- Berberine, which stimulates bile secretion and promotes healthy gut flora.
- Dandelion root, which may help with constipation
- Andrographis, an herb known to balance gut flora
6. Try These Gut Health-Promoting Supplements
Herbs such as slippery elm bark offer a natural source of mucilage, which helps soothe and protect the stomach and GI tract, Dr. Rawls says. Cardamom also includes soothing phytochemicals and helps promote healthy gut bacteria.
Also, consider digestive enzymes like protease, amylase, lipase, and lactase, which help your body break down proteins, fats, and sugars. Your body naturally produces fewer enzymes with age, so adding them back to your diet via supplements can help ensure proper, healthy digestion, Dr. Rawls says.
While you can’t stop or turn back time, taking care of your digestive system and health now will have long-term positive effects on your longevity and well-being. But don’t take our word for it — listen to your gut.
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