Diarrhea and malabsorption in the elderly

Diarrhea from infectious organisms is common in the elderly and leads to frequent hospitalizations and a relatively high mortality rate in this population. Diarrhea can be a disabling manifestation of several systemic disorders, including diabetes mellitus, and drug-induced diarrhea is particularly common in advanced age. Although the physiologic functions of intestinal digestion and absorption of macronutrients and most micronutrients are not decreased simply as a function of aging, malabsorptive diseases including chronic pancreatitis and celiac disease are commoner in the elderly than has been realized in the past. A particular potential cause of covert malabsorption of macro- and micronutrients in older patients is bacterial overgrowth, which may occur in the absence of "blind loops." The impact of silent malabsorption on the nutritional health of older patients may be severer than in the young.