Gastrointestinal Disorders CPG

Although aging has relatively minimal effects on gastrointestinal (GI) function, age-related changes can cause or contribute to several GI disorders. Aging can result in impaired function of the gastric mucosal barrier and increased risk of peptic ulcer disease. Patients residing in PALTC facilities typically have concurrent conditions and use numerous medications that may complicate the assessment and treatment of GI disorders. GI disorders may be caused or exacerbated by a variety of conditions that are more prevalent with age. Fecal impaction and dehydration are sentinel events that may indicate a patient has or is at high risk for a GI disorder. In addition, the presentation of many GI disorders in older people is atypical. For example, GERD may present as dysphagia, asthma, recurrent aspiration pneumonia, or even a cough. These conditions can prevent patients from participating in activities, hinder their mobility, disrupt their sleep, and cause them to become socially isolated. This guideline focuses on GI disorders most commonly seen in the long-term care population.

The following outcomes may be expected from implementation of this clinical practice guideline:

• Reduced incidence of some acute GI disorders and greater stability of chronic GI disorders;
• Appropriate use of medications to treat GI disorder;
• Appropriate use of acute care facilities to assess and treat GI disorders if indicated;
• Appropriate use of specialist referrals and invasive testing in the management of GI disorders;
• Reduced morbidity, mortality, and incidence of complications (e.g., fecal impaction, dehydration) of GI conditions; and
• Improved palliative care outcomes in residents with poor prognosis.