The ageing gut: a study of intestinal absorption in relation to nutrition in the elderly
Montgomery, R.D.; Haeney, M.R.; Ross, I.N.; Sammons, H.G.; Barford, A.V.; Balakrishnan, S.; Mayer, P.P.; Culank, L.S.; Field, J.; Gosling, P.
Quarterly Journal of Medicine 47(186): 197
1978
ISSN/ISBN: 0033-5622 PMID: 684155 Document Number: 128791
This study assessed the functional efficiency of the aging small intestine and the possible role of malabsorption in old people with nutritional deficiencies. Fifty subjects aged 65-92 yr were studied, of whom 33 presented with anemia, chronic diarrhea or bone pains, and 17 were apparently healthy controls with no relevant symptoms. Tests of intestinal function included blood xylose and Fe absorption curves, a double isotope Schilling test, fecal fat, urinary indican and small bowel radiology, with duodenal aspiration and jejunal biopsy in some cases. On the basis either of steatorrhea or at least 2 other abnormal parameters of absorption, there were 15 cases of malabsorption. Thirteen of these had symptoms but 2 were controls. Four of these had duodenal diverticulosis, 2 had the post-gastrectomy syndrome, and one had calcific pancreatitis. Malabsorption in the remaining 8 cases was not fully explained. The age range of this last group was 72-86 yr; 1 of them had a contaminated small bowel and 2 showed some evidence of pancreatic insufficiency. Malabsorption emerged as a significant cause of low levels of serum Fe, Hb and Ca. The blood xylose test is a useful screening procedure for intestinal malabsorption in old age, but full evaluation calls for investigation of pancreatic function.