Q&A: Advise patients of ‘healthy diet, lifestyle choices at any age’ to avoid bloating
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Occasional bloating is common in most individuals, but for some, aging can contribute to an increase in gas as gastrointestinal motility slows, leading to an uptick in bloating and other GI symptoms.
“As people get older, their metabolism tends to slow down and they produce less stomach acid, which means digestion of foods can become more difficult,” Tingting Tan, MD, PhD, a medical oncologist and hematologist at City of Hope Newport Beach in California, told Healio. “In addition, food moves through the digestive tract more slowly as people age. Gas and bloating are a common result of these changes.”
In an interview with Healio, Tan discussed the effects of aging on the GI tract, ways to reduce bloating and other GI symptoms, and how physicians can help older patients maintain optimal GI health.
Healio: How does aging affect the digestive tract?
Tan: As people get older their digestive tract function typically slows down, which means they may need to increase their fiber and water intake to help keep it moving. Also, less stomach acid is produced in older people, and that means some vitamins and minerals are not as easily absorbed, so those levels should be monitored. The sense of thirst declines in older people which can lead to dehydration, and the kidney, liver and pancreas may not function as well in some people as they age.
Healio: When does digestive function start to decline?
Tan: Instead of thinking about a specific age when the digestive functioning might start to decline, it may be more useful to remind patients that they can make healthy diet and lifestyle choices at any age.
For instance, eating a plant-based, high-fiber diet, cutting back on red and processed meat, getting regular exercise, not smoking and reducing or eliminating alcohol has been shown to prevent colon cancer, one of the most common cancers in America.
Healio: Why are women more affected than men?
Tan: Bloating can affect women during their menstrual cycle and during perimenopause. One reason is that estrogen is connected to water retention; another is that both estrogen and progesterone can affect motility or how fast food travels through the digestive system.
Healio: How can patients reduce bloating?
Tan: When patients complain about bloating, one of the first things I do is review their diet to see if it includes foods with [fermentable oligosaccharides, disaccharides, monosaccharides and polyols (FODMAPs)]. These sugars are found in the so-called high-FODMAP foods, such as milk, yogurt, ice cream, beans and lentils, apples, cereal, bread, crackers, onions and garlic among other foods. For some people the sugars are not easily absorbed by the small intestine, and this leads to bloating. When patients tell me they’re experiencing bloating and gas, I suggest they try the FODMAP diet, which is low in those culprit foods, and see if that alleviates the discomfort.
Sometimes a diet change is all that’s needed to ease bloating. But if that doesn’t work, then I need to determine if the patient has a condition such as irritable bowel syndrome or celiac disease that may require medical treatment.
Healio: What other GI symptoms might patients experience as they age?
Tan: Other age-related symptoms of declining digestive function include constipation, heartburn due to GERD, and gas or cramping due to diverticulosis.
Healio: Should physicians discuss these age-related changes with patients?
Tan: Yes, because there are steps patients can take to slow the decline or at least alleviate the symptoms. For instance, for mild constipation, a fiber-rich diet, water and exercise may help. And there are many tricks for remembering to stay hydrated, which are important for anyone to know about because dehydration can negatively impact healthy digestion.
Healio: What other recommendations do you have for patients as they get older?
Tan: For a healthy digestive tract, I recommend to my patients that they eat a balanced, plant-based diet, get regular exercise, drink water, maintain a normal weight and get enough sleep. I also encourage them to tell me about symptoms such as bloating or constipation, so we can find the cause and do whatever is possible to alleviate those symptoms.
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