positive outcomes in randomised controlled trials.
When diarrhoea and faecal urgency predominate, loperamide can be beneficial; a liquid formulation, if available, makes dose titration easier. Alosetron (a 5‐HT3 antagonist) may have a place in diarrhoea‐predominant IBS in women, but the association of this drug with ischemic colitis suggests the need to exercise caution, especially in older patients. Randomised controlled trials have included only a few patients over 65.
Key points
Gastrointestinal motor function is relatively well preserved with healthy ageing, but a general decline in visceral sensation is evident.
Systemic illnesses and medication use often impair gut function in the elderly.
The consequences of disturbed gut motility and sensation include swallowing disorders, impaired nutrition and absorption of medications, and altered bowel habits.
Functional gastrointestinal disorders are prevalent in the elderly, but organic disease must always be rigorously excluded.
Acknowledgements
The authors wish to thank Dr Paul Kuo, Department of Gastroenterology and Hepatology, Royal Adelaide Hospital, for providing examples of pressure topography plots used in the figures.
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