So THAT’S Why Your Stomach Hurts More As You Get Older

Plenty of surprises come with the aging process (like those weird noises our joints make or the monster hangovers that follow two sips of beer). But few are more of a bummer than the way our digestive system seems to lose interest in, well, digesting things.

“Intestinal issues can arise at any age and can become more prevalent as we age,” Dr. Sara Attalla, a gastroenterologist at Inspira Health in New Jersey, told Wispria.

Roughly 60 million to 70 million Americans are affected by digestive diseases, according to the National Institutes of Health. Some of the most common symptoms? Heartburn, bloating, abdominal pain and changes in bowel habits (as in constipation, diarrhea or even a combo of the two).

Nailing down what’s causing your digestive drama can be tricky since it’s a multi-faceted problem that typically stems from a highly individual combination of aging and lifestyle-related culprits.

As we age, the nerves and muscles in the gastrointestinal (GI) tract can start to glitch, resulting in changes to how our digestive organs function individually and work together — usually, this translates into the digestion process itself becoming sluggish and communication signals between digestive organs getting haphazard.

Movement within the esophagus and muscles involved in swallowing may not be as effective or coordinated, for instance, and can lead to higher rates of esophageal reflux (known as GERD, where your stomach contents start to make a comeback), while slower motility in the stomach can cause what you’ve eaten to linger and trigger indigestion.

“The stomach lining can also become thinner with age, which renders you more susceptible to injury in the stomach from things like inflammation,” Attalla said.

Decreased prostaglandin production over time (a hormone-like substance that plays a role in stomach acid secretion and GI muscle functioning) means a decrease in the protective lining of the stomach, too, leaving you more prone to gastritis and ulcers.

The next stop on your food’s digestive journey is a pit stop in the small bowel. “Slower motility here can lead to higher rates of bacterial overgrowth, which can cause bloating and diarrhea,” Dr. Sunana Sohi, a board-certified gastroenterologist at Gastroenterology Health Partners in Louisville, Kentucky, told Wispria.

And if motility screeches to a halt in your colon, get ready for possible bouts of constipation and diverticulosis (a condition where small sacs form and push against weak spots in the wall of your colon, putting you at risk of symptom flareups, such as bleeding and inflammation).

Then there’s the chronic health conditions that tend to stack up as we get older (arthritisis, cardiovascular and metabolic diseases), many of which can cause limitations to the level of movement we can tolerate, further exacerbating gut motility issues. (“If you don’t move, neither does your gut,” Dr. Pritesh Mutha, an associate professor at McGovern Medical School at UTHealth Houston, told Wispria.)

As for the medications we take to manage these conditions (both prescription and over-the-counter, especially NSAID pain relievers such ad aspirin and ibuprofen), they’re known to cause gastro-themed side effects of their own. Cue nausea, constipation, diarrhea, abdominal pain, even ulcers.

All of this is understandably frustrating and concerning. But experts stress there are ways to minimize any effects from age-related stomach issues. They recommend:

Better digestion begins in the mouth. “Salivary enzymes help digest starch and fat in the mouth, decreasing the GI tract’s workload,” Mutha said. “The alkaline pH of saliva also helps neutralize acid in the esophagus due to reflux and alleviate GERD symptoms.”

Bonus: Cutting your food into smaller pieces and chewing at least 15 to 20 times per bite can help mitigate any complications associated with trouble swallowing.

Saliva production tends to decrease as we age, which can affect chewing and swallowing, Sohi said. According to the American Dental Association, dry mouth is twice as likely to strike when you take one or more medications daily, compared with people with no medications on their roster.

Things like regularly using an over-the-counter saliva substitute or sipping water between bites can be helpful if dry mouth is a problem for you at mealtime.

The best way to optimize digestion is to eat a diet as low in processed foods and high in plant-based diversity as possible. “Diets high in processed food can alter the gut microbiome, leading to dysbiosis,” Sohi said, an unhealthy balance of gut bacteria that’s associated with higher rates of digestive disease.

Besides keeping your gut microbiome on the rails, going plant-based is the best way to increase your fiber intake, which is crucial to the quality and consistency of your number two sessions.

Fiber — soluble and insoluble — is what bulks up your poop, Mutha explained. This not only makes your time on the throne more pleasant and efficient, but it also decreases the likelihood of fecal incontinence and even helps treat diarrhea by absorbing water.

Hydration is crucial to avoid constipation, Mutha said, especially once you start upping your fiber intake. The National Council on Aging recommends drinking one-third of your weight in fluid ounces daily. That means if you weigh 150 pounds, then you should be drinking 50 ounces (or 6¼ cups) of water per day.

“Exercise stimulates the motility of the GI tract, so this can be very helpful for digestion,” Sohi said. “Lying recumbent on the couch after eating is one of the worst things you can do because not only does it not help with GI tract motility, but it can also promote acid reflux.”

Mutha agrees and recommends walking for roughly 15 minutes after your meals to help activate your stomach and improve gastric emptying.

Sleep is a healing mechanism for the body, so not getting enough quality shut-eye — the recommendation is seven to nine hours per night — can adversely affect your gut barrier and immunity, Mutha said. Researchers are still nailing down the exact mechanisms behind how, but one theory is that sleep deprivation leads to an increase in microscopic inflammation in the bowel that may domino into gastrointestinal symptoms.

“Any and every medicine has GI side effects — even the ones that are prescribed for GI illnesses,” Mutha said. “Making sure you take your medications exactly as prescribed decreases the risk of side effects.”

NSAIDs should never be consumed on an empty stomach, for instance, while acid-suppressive medicines should be taken 30 minutes before breakfast. But if side effects happen anyway, let your doctor know.

Even if you’re confident the digestive drama you’re experiencing is aging-related or a sign your lifestyle needs a revamp, “it’s important to not assume” and to “share your symptoms with your doctor anyway, as sometimes there can be a more serious underlying cause,” said Dr. Neena Mohan, gastroenterologist and assistant professor of clinical medicine at the Lewis Katz School of Medicine at Temple University in Philadelphia.

If, in addition to persistent changes in bowel habits, you’re also experiencing trouble swallowing, abdominal pain, nausea and/or vomiting, unexplained weight loss or have noticed blood in your poop (or it looks black and tarry), it’s time for a consultation with a gastroenterologist.

“Depending on the issue, your doctor may start with bloodwork and prescribe medications or do further testing, such as an endoscopy or colonoscopy,” Attalla said.