Subject Index Achalasia course 93 differential diagnosis 93 esophageal dysphagia 92 95 etiology 92, 93 treatment 93 95 work-up 93 Aminosalicylates, pharmacokinetics and aging effects 36 Antibiotics diarrhea induction 178, 179, 191, 192 Helicobacter pylori infection management 135 137, 139 pharmacokinetics and aging effects 34, 35 Atrophic gastritis epidemiology 44, 45 Helicobacter pylori infection 130, 131 Azathioprine, pharmacokinetics and aging effects 36 Barrett esophagus cancer risks 42 cyclooxygenase-2 expression 42, 43 epidemiology 42, 87 esophageal dysphagia 87, 88 management 88 p53 mutations 43 symptoms 87, 88 Bismuth salts, pharmacokinetics and aging effects 33 Celiac disease autoimmunity 194 clinical presentation 180, 194 epidemiology 180 management 180, 181 Cirrhosis epidemiology 5, 6, 172 primary biliary cirrhosis 172, 173 Colon aging effects 62, 63 cancer, see Colorectal cancer diverticulosis, see Diverticulosis Colorectal cancer age and sex differences 200 202, 209 clinical presentation 196, 203, 204 diarrhea 195, 196 epidemiology 9, 10, 200 202 genetics 51 polyp dwell time 204, 207 prognostic factors 207 proximal colon shift in occurrence 202, 203 screening tests 204 207 staging 207 treatment chemotherapy 208, 209 palliative therapy 208 surgery 207, 208 Computed tomography colonography 206 gastric cancer 150, 151 pancreas imaging 72, 158 161 213
Constipation, epidemiology 8 Corticosteroids, pharmacokinetics and aging effects 35, 36 Cricopharyngeal bar, dysphagia 81 Crohn disease, see Inflammatory bowel disease Cyclooxygenase COX-2 Barrett esophagus expression 42, 43 inhibitor use with non-steroidal antiinflammatory drugs 123, 124 isoforms and functions 120, 121 Cytochromes P450 aging effects 30 32, 70, 71 isoforms and drug metabolism 32 Dermatomyositis, oropharyngeal dysphagia 79 Diarrhea acute vs chronic 177, 187 colon cancer 195, 196 definition 177, 187 diabetes 179 diagnosis 197, 198 drug induction 178, 179, 190 192 endocrine and metabolic causes 197 epidemiology 8 gastric motility 188 intestinal flora 189 irritable bowel syndrome 195 management 198 mechanisms mucosal damage 189 osmotic diarrhea 189 secretory diarrhea 189 sodium-potassium exchange pump 189, 190 microscopic colitis 197 mortality 176, 177 pancreatic causes 194 pathogens 177, 178, 192 predisposing factors 187 189 prevention 198 radiation enteropathy 192 small bowel bacterial overgrowth 180, 181, 193 small bowel resection association 192 tropical sprue 193 Whipple disease 193 Diverticulosis bacterial overgrowth syndrome 181 epidemiology 8, 9 features 196 treatment 196 Domperidone, pharmacokinetics and aging effects 33 Dyspepsia, epidemiology 2 Dysphagia definition 76 diagnosis 76, 77 epidemiology 2, 76 esophageal dysphagia etiology and management achalasia 92 95 Barrett esophagus 87, 88 dysphagia aortica 92 esophageal cancer 89 91 esophageal webs 89 gastroesophageal reflux disease 84 86 mechanical obstruction 83, 84 medication-induced injury 91, 92 motility disorders, overview 92, 95, 96 overview 83 peptic strictures 86 Schatzki ring 88, 89 scleroderma 96 oropharyngeal dysphagia etiology cerebrovascular accidents 77, 78 cricopharyngeal dysfunction 81 dermatomyositis 79 myasthenia gravis 79, 80 myotonic dystrophy 79 obstructive lesions 80 oculopharyngeal dystrophy 79 overview 76, 78 Parkinson disease 78, 79 polymyositis 79 sialoporia 81, 82 Zenker diverticulum 80 treatment 82, 83 swallowing anatomy and physiology 40, 41 Subject Index 214
Epidermal growth factor receptor, expression in gastrointestinal cancers 50, 51 Esophageal body, aging changes 41, 75 Esophageal cancer adenocarcinoma 91 epidemiology 3, 89, 91 esophageal dysphagia 89 91 squamous cell cancer clinical features 89 lesion detection 89 treatment 90, 91 Esophageal webs, dysphagia association 89 Esophagitis, epidemiology 3, 4 Fecal incontinence causes 196 epidemiology 8 treatment 196 Gallbladder cancer, epidemiology 7 Gallstone, epidemiology 7 Gastric cancer classification 146 clinical presentation 146, 147, 155 computed tomography 150, 151 diagnosis barium meal 150 endoscopy 148 151 laboratory tests 148 epidemiology 5, 50, 51, 145, 146 epidermal growth factor receptor expression 50 etiology 147, 148 Helicobacter pylori infection 147, 148 management chemotherapy 153, 154 palliative therapy 154, 155 surgery 151 153, 155 metastasis 155 Gastric mucosa acid secretion 46 aging changes 43, 44, 46 susceptibility, see Non-steroidal antiinflammatory drug gastropathy proliferative activity cell cycle regulation 48 gastrectomy effects 46 growth factors and receptors 48 50 nutrition effects 49 rat studies 47, 48 protective function classification 119, 120 Gastroesophageal reflux disease consequences 74, 84 diagnosis barium radiography 104 endoscopy 104 manometry 105 ph testing 104, 105 proton pump inhibitor trial 105 epidemiology 2, 3, 84, 100 esophageal dysphagia 84 86 Helicobacter pylori infection 132, 133 pathophysiology 100, 101 risk factors 101, 102 swallowing anatomy and physiology 40 42 symptoms 84, 85, 100 104 treatment cost analysis 113 H 2 blockers 85, 107, 109 lifestyle and diet modification 85, 106 long-term medical treatment 108 113 prokinetic agents 85, 86, 106, 107, 109 proton pump inhibitors 86, 107 112 quality of life impact 111 safety 111, 112 short-term medical treatment 106 108 surgery 86, 112, 113 Gastrointestinal bleeding, epidemiology 5 Geriatric assessment effectiveness of assessment programs 20 23 health status screening scales 16, 17 historical perspective 13, 14 inpatient setting 17 multidimensional assessment 19 office practice setting 17 19 overview 12, 13 prospects 23, 24 structure and process 14 17 Subject Index 215
P-Glycoprotein, aging changes in expression 37, 67 H 2 antagonists gastroesophageal reflux disease management 85, 107, 109 damage prevention 124, 125 pharmacokinetics and aging effects 33, 34 Helicobacter pylori infection chronic atrophic gastritis 130, 131 clinical characteristics in elderly vs young subjects 138, 139 diagnosis 134 effects in stomach 46 epidemiology 4, 128 extradigestive disease role 133 gastric cancer role 147, 148 gastroesophageal reflux disease 132, 133 use effects 131, 132 nonulcer dyspepsia 129, 130 nursing home residents 133 peptic ulcer disease, see Peptic ulcer treatment compliance 139 drug pharmacokinetics and aging effects 33 35 drug side effects and dosing 136, 137 incidence in elderly 128 posttreatment evaluation 134, 135 regimens 135, 136 risk factors for treatment failure 137, 139 urea breath test 134, 135 virulence factors 46 Hepatitis autoimmune hepatitis 172 hepatitis A virus 168 hepatitis B virus 168 hepatitis C virus 169, 170 hepatitis delta virus 168 hepatitis G virus 170 management 173, 174 TT virus 170 Inflammatory bowel disease diagnosis 183 differential diagnosis 184 drug pharmacokinetics and aging effects 35, 36 epidemiology 182, 183, 197 malignancies 184 management 183, 184, 197 Infliximab, pharmacokinetics and aging effects 36 Irritable bowel syndrome definition 195 diagnosis 195 epidemiology 9, 195 treatment 195 Ischemic colitis clinical presentation 196 epidemiology 9 Lactose intolerance, features and treatment 195 Liver aging effects clinical considerations 71 cytochrome P450 expression 30 32, 70, 71 function 67, 168 morphology 58, 65 67, 168 regeneration 67, 68, 70 alcohol effects, see Cirrhosis alcoholic disease 172 drug damage 170 172 hepatitis, see Hepatitis transplantation 174 Lower esophageal sphincter, aging changes 41, 42, 75, 76 6-Mercaptopurine, pharmacokinetics and aging effects 36 Metoclopramide, pharmacokinetics and aging effects 33 Misoprostol damage prevention 124 pharmacokinetics and aging effects 33 Myasthenia gravis diagnosis 79, 80 Subject Index 216
oropharyngeal dysphagia 79, 80 Myotonic dystrophy, oropharyngeal dysphagia 79 Non-steroidal antiinflammatory drug gastropathy clinical presentation and consequences 121, 122 epidemiology 4, 44, 45, 118, 119 Helicobacter pylori infection 131, 132 mechanisms of damage 119 121 prevention COX-2 inhibitor use 123, 124 discontinuation of drug 122 H 2 antagonist treatment 124, 125 less damaging drug use 123 misoprostol treatment 124 proton pump inhibitor treatment 124, 125 relative risks by drug type 123 p53, Barrett esophagus mutations 43 Pancreas aging effects acinar cell loss 58 function 72, 158, 159 imaging findings 72, 158 161 morphology 71, 72 structural changes 157, 158 cancer, see Pancreatic cancer pancreatitis, see Pancreatitis Pancreatic cancer epidemiology 6, 7, 164 surgery 164, 165 Pancreatitis acute pancreatitis features and management 161 163 chronic pancreatitis features and management 162 164, 179 epidemiology 6, 7 Parkinson disease, oropharyngeal dysphagia 78, 79 Pepsinogen, aging effects on secretion 47 Peptic ulcer epidemiology 4, 5, 128, 129 Helicobacter pylori infection 129 Periodontitis, epidemiology 1, 2 Pharmacokinetics, aging effects body composition changes and drug distribution 29, 30 P-glycoprotein expression 31, 61 inflammatory bowel disease drugs 35, 36 intestinal absorption 28, 29, 60, 61 liver changes and cytochromes P450 30, 31 renal drug elimination 30, 37 study design 28 upper gastrointestinal tract disorder drugs 31, 33 35 Pharynx, aging changes 75 Polymyositis, oropharyngeal dysphagia 79 Proton pump inhibitors drug-drug interactions 108 gastroesophageal reflux disease diagnosis 105 management 86, 107 112 Helicobacter pylori infection management 135 137 damage prevention 124, 125 pharmacokinetics and aging effects 33 35 Radiation therapy, enteropathy 192 Schatzki ring esophageal dysphagia 88, 89 management 88, 89 Scleroderma, esophageal dysphagia 96 Sialoporia causes 81 oropharyngeal dysphagia 81, 82 Small intestine aging effects carbohydrate absorption 58 cell proliferation 61 drug absorption, see Pharmacokinetics, aging effects fat absorption 59 history of study 57, 58 mineral absorption 59 motor function and motility 61, 62 stress response 62 vitamin absorption 59, 60 Subject Index 217
Small intestine (continued) bacterial overgrowth 180, 181, 193 cancer 181, 182 diarrhea, see Diarrhea disorders in elderly patients 176 inflammatory bowel disease, see Inflammatory bowel disease malabsorption disorders celiac disease 180, 181, 194 lactose intolerance 195 overview 179 motility and diarrhea 188 vascular disease 182 Stomach cancer, see Gastric cancer functional changes in aging 45 47 Helicobacter pylori infection, see Helicobacter pylori infection maintenance of structural and functional integrity 47 50 susceptibility, see Non-steroidal antiinflammatory drug gastropathy structural changes in aging 43 45 ulcer, see Peptic ulcer Stroke oropharyngeal dysphagia 77, 78 recovery 77, 78 Sucralfate, pharmacokinetics and aging effects 31, 33 Tropical sprue, features and treatment 193 TT virus, hepatitis 170 Ulcerative colitis, see Inflammatory bowel disease Ultrasound, pancreas imaging 72, 158 161 Upper esophageal sphincter, aging changes 75 Urea breath test, Helicobacter pylori infection 134, 135 Whipple disease, features and treatment 193 Xerostomia, see Sialoporia Zenker diverticulum formation 80 oropharyngeal dysphagia 80 Subject Index 218