The Ageing of the Human Lower Bowel.

IF 1.8 4区 医学 Q3 MEDICINE, GENERAL & INTERNAL
British journal of hospital medicine Pub Date : 2025-07-25 Epub Date: 2025-07-04 DOI:10.12968/hmed.2024.0734
Nicholas Baidoo, Gareth J Sanger
{"title":"The Ageing of the Human Lower Bowel.","authors":"Nicholas Baidoo, Gareth J Sanger","doi":"10.12968/hmed.2024.0734","DOIUrl":null,"url":null,"abstract":"<p><p>Older people suffer a greater number of disorders of the gastrointestinal tract, including chronic constipation and faecal incontinence. In this review, we examine the age-related degenerative changes that have been identified in the lower bowel of humans. Firstly, older individuals may experience less abdominal pain and a lower incidence of gut-brain disorders that are defined partly by abdominal pain (e.g., irritable bowel syndrome); the causes are unclear. Secondly, an age-dependent reduction in mucosal barrier functions may follow a decline in intestinal stem cell activity, a reduced density of tight junction proteins linking epithelial cells and a decline in mucus layer thickness. This allows antigenic and toxic material to enter the wall of the colon. Thirdly, degenerative changes within the wall of the colon occur in both the ascending and descending regions, but the ascending colon appears most vulnerable. Here, there is reduced cholinergic neuromuscular function (potentially reducing colonic motility), perhaps because of dysfunctional nerve axon transport, and associated senescence-like activity. These changes lower the 'intestinal reserve', that is the capacity of neuromuscular functions to absorb other 'life events' that affect bowel motility (e.g., changes in lifestyle or eating habits, medications that affect neuromuscular functions and diseases such as diverticulosis) without generating symptoms such as constipation. When combined, symptoms are more likely to develop.</p>","PeriodicalId":9256,"journal":{"name":"British journal of hospital medicine","volume":"86 7","pages":"1-16"},"PeriodicalIF":1.8000,"publicationDate":"2025-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"British journal of hospital medicine","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.12968/hmed.2024.0734","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2025/7/4 0:00:00","PubModel":"Epub","JCR":"Q3","JCRName":"MEDICINE, GENERAL & INTERNAL","Score":null,"Total":0}
引用次数: 0

Abstract

Older people suffer a greater number of disorders of the gastrointestinal tract, including chronic constipation and faecal incontinence. In this review, we examine the age-related degenerative changes that have been identified in the lower bowel of humans. Firstly, older individuals may experience less abdominal pain and a lower incidence of gut-brain disorders that are defined partly by abdominal pain (e.g., irritable bowel syndrome); the causes are unclear. Secondly, an age-dependent reduction in mucosal barrier functions may follow a decline in intestinal stem cell activity, a reduced density of tight junction proteins linking epithelial cells and a decline in mucus layer thickness. This allows antigenic and toxic material to enter the wall of the colon. Thirdly, degenerative changes within the wall of the colon occur in both the ascending and descending regions, but the ascending colon appears most vulnerable. Here, there is reduced cholinergic neuromuscular function (potentially reducing colonic motility), perhaps because of dysfunctional nerve axon transport, and associated senescence-like activity. These changes lower the 'intestinal reserve', that is the capacity of neuromuscular functions to absorb other 'life events' that affect bowel motility (e.g., changes in lifestyle or eating habits, medications that affect neuromuscular functions and diseases such as diverticulosis) without generating symptoms such as constipation. When combined, symptoms are more likely to develop.

人类下肠的衰老。
老年人患有更多的胃肠道疾病,包括慢性便秘和大便失禁。在这篇综述中,我们研究了与年龄相关的退行性变化,这些变化已经在人类的下肠中被发现。首先,老年人可能较少出现腹痛,也较少出现部分由腹痛定义的肠-脑疾病(如肠易激综合征);原因尚不清楚。其次,肠道干细胞活性下降、连接上皮细胞的紧密连接蛋白密度降低和黏液层厚度下降可能导致粘膜屏障功能的年龄依赖性降低。这使得抗原和有毒物质进入结肠壁。第三,升结肠和降结肠均可发生结肠壁内的退行性改变,但升结肠最为脆弱。这里,胆碱能神经肌肉功能降低(可能降低结肠运动),可能是因为神经轴突运输功能障碍和相关的衰老样活动。这些变化降低了“肠道储备”,即神经肌肉功能吸收影响肠道运动的其他“生活事件”的能力(例如,生活方式或饮食习惯的改变,影响神经肌肉功能的药物和憩室病等疾病),而不会产生便秘等症状。当两者结合时,症状更有可能出现。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
求助全文
约1分钟内获得全文 求助全文
来源期刊
British journal of hospital medicine
British journal of hospital medicine 医学-医学:内科
CiteScore
1.50
自引率
0.00%
发文量
176
审稿时长
4-8 weeks
期刊介绍: British Journal of Hospital Medicine was established in 1966, and is still true to its origins: a monthly, peer-reviewed, multidisciplinary review journal for hospital doctors and doctors in training. The journal publishes an authoritative mix of clinical reviews, education and training updates, quality improvement projects and case reports, and book reviews from recognized leaders in the profession. The Core Training for Doctors section provides clinical information in an easily accessible format for doctors in training. British Journal of Hospital Medicine is an invaluable resource for hospital doctors at all stages of their career. The journal is indexed on Medline, CINAHL, the Sociedad Iberoamericana de Información Científica and Scopus.
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
确定
请完成安全验证×
copy
已复制链接
快去分享给好友吧!
我知道了
右上角分享
点击右上角分享
0
联系我们:info@booksci.cn Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。 Copyright © 2023 布克学术 All rights reserved.
京ICP备2023020795号-1
ghs 京公网安备 11010802042870号
Book学术文献互助
Book学术文献互助群
群 号:604180095
Book学术官方微信