The ageing gut: diminished symptom response to a standardized nutrient stimulus

Background: The prevalence of dyspepsia and the severity of reflux symptoms decreases with advancing age. We postulate that advancing age influences sensory function and this will be associated with a diminished symptom response to a standardized meal stimulus.Our aim was to assess the influence of age on visceral sensory function. Methods: Baseline gastrointestinal symptoms and anxiety and depression were assessed in 53 healthy volunteers using validated questionnaires. After an 8-h fast, subjects received 200 mL of a standardized enteral feeding solution every 5 min up to a cumulative volume of 800 mL. After each 200 mL drink, five key symptoms were assessed (fullness, abdominal pain, retrosternal/abdominal burning, nausea and regurgitation) using a standardized instrument on visual analogue scales (0–100). The cumulative symptom score across all symptoms was calculated. Key Results: Fullness was the most prominent symptom reported (79.8 ± 9.5) followed by nausea (14.9 ± 4.9) and pain (9.8 ± 4.5); these three items accounted for more than 90% of the overall symptom load. The cumulative pain and nausea scores during a standardized nutrient challenge were significantly and inversely correlated with age (r = −0.43, P = 0.002 and r = −0.28, P = 0.045). Subjects >60 years of age reported significantly lower pain and nausea scores (0.9 ± 0.9, 4.5 ± 3.9) than did subjects