Esophageal Dysphagia in the Elderly

Tailoring meat products for the elderly: A comprehensive review

The population of the elderly is projected to grow significantly in most of the developed countries in the near future. This should earn this demographic the title of 'Consumer of the future'. Meat has high quality proteins and essential vitamins which are important for all demographics but more so for the elderly due to their susceptibility to sarcopenia. This review explored the landscape of meat research and product development that meets the distinctive requirements of the elderly, drawing from published refereed articles, industry reports, and unpublished grey literature. The review emphasised the importance of understanding the evolving dietary and sensory requirements associated with ageing and how they intersect with meat consumption. One notable aspect observed is the diversity within the elderly population, which underscores the necessity for tailored approaches in meat product development to cater to the varying preferences and nutritional needs of different individuals. This review also highlights the ongoing efforts in developing meat-based products that span a spectrum of consistencies, ranging from solid to liquid forms, to accommodate the diverse needs of elderly consumers. Despite these advancements, the review found a discrepancy between the pace of meat product development for the elderly and the rapid advancements in kitchen-level technologies and suggests that further research is needed to bridge this gap and align product innovation with emerging technological trends.

Opioid-Induced Esophageal Dysmotility (OIED) - A Case Report

Recent studies have shown that chronic opioid use is associated with an increased risk of symptomatic esophageal motility disorders. Opioid-induced esophageal dysfunction (OIED) is most often identified in patients taking high doses of opioids. This condition is associated with poorer treatment outcomes than primary motility disorders and management of these cases is further complicated by the presence of chronic pain, opioid addiction, and physical and psychological comorbidity.We present the case of a 68-year-old Caucasian woman with OIED, induced by the chronic intake of low-dose Fentanyl and Tramadol prescribed to treat severe back pain. The clinical course highlights the sometimes difficult diagnosis and management of this recently recognized condition.

Prevalence of elderly eosinophilic esophagitis and their clinical characteristics

BACKGROUND AND AIMS

Eosinophilic esophagitis (EoE) is predominantly found in middle-aged men among adults. There are few reports about EoE in the elderly, despite an ageing population. The study aimed to define the prevalence and clinical characteristics of EoE amongst older adults.

METHODS

Elderly patients (defined as those ≥65 years) were compared to younger adults (18-64) in terms of clinical characteristics (age, gender, presenting symptoms, comorbidities), histological activity (eosinophil count), treatment modality and response to treatment. A pre- existing prospectively generated database of all EoE patients presenting to our department between February 2010 and December 2022 was interrogated. 309 patients who underwent endoscopy and esophageal biopsy and were found to have ≥15 eosinophils/HPF were defined as having EoE and were included for study. Statistical analyses were performed using Fisher's extract test or Mann-Whitney U test.

RESULTS

309 cases of EoE were recorded, mean age 45.7, range (21-88 years), of which20 patients were aged 65 years and over. Compared to younger patients, those aged ≥65 had more medical comorbidities (15 [75%] vs 111[38%], p = 0.002), and instead a non-significant trend toward less fibrosis (0.25 vs 0.46, p = 0.117). Although rate of cases required topical steroid (TCS) therapy was similar, none received repeated or maintenance TCS therapy in elderly.

CONCLUSION

In our cohort, only 20 patients (6%) were aged 65 years or older, suggesting that EoE is uncommon in the elderly. The clinical characteristics of EoE in the older age group were similar to the younger patients. Future studies with prospective data collection may determine if EoE disappears with age, or if the younger mean age is reflective of an increasing prevalence in recent years, that may be realized in the elderly EoE population in the future.

Non-neoplastic disorders in an aging gut: concise review

The spectrum of gastrointestinal (GI) issues in the older population varies from common physiological age-related changes to devastating, less common sinister pathological illness. GI system has direct exposure to external environment. Thus, it is modeled to embrace the pathophysiological changes that occur due to interaction with external factors. Gastrointestinal tract (GIT) per se is more resilient to aging as compared to other organ systems. On the other hand, elderly may present with a large plethora of GI symptoms. This presents a challenge to all echelons of medical consultation for accurate attribution for the aging process or pathophysiological causation of GI symptoms. This dichotomy leads to hindrance in adequate and appropriate treatment of GI ailments. In GI system, non-neoplastic disorders are far more common than neoplastic disorders. Hence, it becomes imperative to understand the aging evolution of the GI system and management of GI disorders in the older population.