No one likes to talk about it much, but “leaky gut,” or the inability to completely control one’s bowels, is one of the most common problems I face as a geriatrician.

This condition usually has its origins in an inflammation, which can have many causes:

Most Serious

• Inflammatory Bowel Disease

Both Crohn’s Disease and ulcerative colitis cause inflammation of the bowel. Thought to be an immune problem, symptoms include diarrhea, often bloody, fatigue, weight loss, and possibly inflammation of the eye or joints. New antibody treatments (Remicade) can be life-changing.

Most Common

• Irritable Bowel Disease

The exact cause of this condition is not known. We know that the colon has a rich network of nerves that affect the colon’s function. For some, anxiety and tension can lead to bowel problems, diarrhea, pain, decreased appetite. Elders can have inflammation of the bowel wall, which can lead to fibrosis and poor gut function.

Less Common Causes

About 2 percent of the population are gluten sensitive because of Celiac Disease and
must avoid wheat products. Symptoms include fatigue, cramping, joint pain, weight loss,
diarrhea are the signs. From 20 to 30 percent of adults are lactose intolerant and should avoid
milk to avoid crampy, bloating pain, and loose stools.

How to Avoid These Problems

If you have been diagnosed with one of the conditions above, several medications can help.

However, common-sense lifestyle changes can make a huge difference. Almost everyone does better with more fiber in their diet: whole grains, unprocessed fruits, and vegetables. Fiber makes you feel full, feeds and encourages a healthy gut microbiome, and reduces colon cancer risk. Limiting alcohol and caffeine will also help gut function. Keep active—exercise at least 30 minutes per day.

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