Chapters 10
 Digestive System - Notes

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1. Name and explain the importance of the six main functions of the digestive system.

     1. supply nutrients           4. store blood
     2. eliminate wastes          5. regulate blood chemistry
     3. vocalization                6. produce hormones

2. Name and briefly explain the digestive system processes involved in supplying cells with homeostatic levels of nutrients.

     1. convert foods to small soluble molecules
     2. absorption
     3. manufacturing certain nutrients (e.g., amino acids)
     4. storing excess nutrients (e.g., vitamins, CHOs {carbohydrates}, AAs {amino acids}, lipids)
     5. converting excess nutrients (e.g., CHOs, AAs, lipids)

 3. Describe age changes (not abnormalities) in the following aspects of the oral region and describe consequences from these age changes: teeth, muscles

     - teeth -> (1) (decr. pulp) -> decr. sensitivity -> decr. warning of damage and decay; (2) loosening teeth and receding of gums -> incr. periodontal disease
     - muscle -> decr. strength and coordination -> decr. swallowing -> incr. choking

 4. Describe abnormal changes in the following aspects of the oral region and describe consequences from these changes: oral mucosa, teeth, muscles.

     - mucosa -> incr. injuries and sores (e.g., dentures, meds) -> pain, altered nutrition, altered personality traits
     - teeth -> incr. decay, incr. periodontal diseases, incr. tooth loss -> pain, altered nutrition, altered taste, altered speech, systemic infection, cosmetic effects, economic effects
     - muscles -> abnormal speaking, difficulty swallowing (e.g., choking, aspiration)

 5. List main ways for preventing or reducing abnormal changes in teeth.

     - fluoride during youth, good dental hygiene throughout life (avoid sweets, brush teeth, regular dental check-ups and treatments)

6. For the esophagus describe two examples of abnormal changes and two effects from them.

     - abnormal -> (e.g., rings, webs, strictures, hiatal hernia, diabetic slowing, stroke, meds, alcohol) -> (1) altered swallowing, (2)incr. refluxing
          - effects = altered diet, stuck meds, discomfort, esophageal ulcers

 7. For the stomach, describe age changes in secretion and their effects and describe two examples of abnormal changes and two effects from them.

     - aging -> slight decr. secretions (HCl, intrinsic factor)-> slight decr. in small intestine absorption of iron, calcium, & vit. B12
     - abnormal
          1. atrophic gastritis -> great decr. secretion -> great decr. absorption of iron, Ca, vit. B12, altered bacteria
          2. acute gastritis -> pain, altered diet, altered meds
          3. peptic ulcer -> pain, bleeding, perforation, stricture, infection

 8. For the small intestine, describe age changes in secretion, its effect on lactose digestion and consequences from lactose intolerance.

     - variable decr. lactase production -> decr. lactose digestion -> gas, pain, discomfort, disability, decr. dairy intake -> decr. Ca

 9. For the large intestine, describe the effects of age changes on defecation including the incidence of constipation and fecal incontinence.

     - slowed transit time -> incr. risk of constipation
     - rectal changes (fibrosis, sphincter weakening, decr. voluntary sphincter control) -> incr. fecal incontinence


10. Name four factors that increase the incidence of constipation with aging and tell three effects from constipation.

     - factors = aging, laxative, delayed defecation, decr. fiber, decr. water, decr. exercise, meds, very great incr. fiber
     - effects  = discomfort, gas, diarrhea, fecal incontinence, hemorrhoids, diverticulosis, etc.

11. Name three factors that increase the incidence of diarrhea with aging and tell three  effects from diarrhea.

     - factors = constipation, laxatives, bacteria, meds, ulcerative colitis, cancer
     - effects = dehydration, salt loss (e.g., heart, brain, BP, muscles), fecal incontinence

12. Name three factors that increase the incidence of fecal incontinence with aging and tell three effects from fecal incontinence.

     - factors = constipation, diarrhea, hemorrhoid surgery, nervous disorders (e.g., stroke, dementias, cord injury), diabetes, immobility
     - effects = skin inflammation, infection, bed sores, social, psychological, institutionalization

13. Name two factors that increase the incidence of diverticulosis and diverticulitis with aging and tell three effects from diverticulitis.

     - factors = constipation, decr. fiber, decr. water,
     - effects = pain, constipation, diarrhea, bleeding, infection, perforation

14. Name two factors that increase the incidence of hemorrhoids with aging and tell three effects from hemorrhoids.

     - factors = constipation, cirrhosis, coughing, childbirth
     - effects = pain, bleeding, infection, surgery

15. Name two factors that increase the incidence of colon cancer with aging and tell three effects from colon cancer.

     - factors = incr. animal fats, incr. sugars, decr. fiber, genetics
     - effects = obstruction, intestinal destruction, metastasis, bleeding

16. Describe the overall effects of aging on functioning of the liver, gall bladder, and pancreas (digestive functions).

    No important changes

17. For cirrhosis of the liver, name three common causes and five effects from cirrhosis including malnutrition, jaundice, and hemorrhoids, and two ways to reduce the risk of developing cirrhosis. (Photos and microscope slides of liver and cirrhosis)

     - causes = gall stones, alcohol, toxins, malnutrition, hepatitis
     - effects = malnutrition, jaundice, hemorrhoids, NH3 toxicity, ascites, edema, bleeding, anemia, weak bones, altered sexual functioning
     - prevention = treat gall stones, avoid alcoholism, avoid toxins, avoid hepatitis

18. For gall stones, describe the two main ways they cause problems and three problems they cause. (Photos of gall stones.)

     - effects = injure gall bladder, block ducts
     - problems = pain, malnutrition, cirrhosis, pancreatitis, infection, perforation

19. Name two ways to reduce the risk of developing pancreatic cancer.

     - avoid smoking, excess fats, nitrates and nitrites, excess coffee

20. Understand and explain that most age-related changes in the digestive system, including abnormalities and diseases, result not form age changes but from abuse, misuse, and disuse of the digestive system or from abnormalities or diseases in other body systems. Therefore, most age-related problems in the digestive system are preventable to some degree.

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