Excerpt from The Hahnemannian Monthly: January, 1922; Digestive Disturbances of the Aged From the Standpoint of the Internist
From a clinical standpoint the gastric disturbances of the aged may be divided in three classes: 1. Those secondary to organic disease of other viscera. 2. Due to arterio sclerosis. 3. Functional or atrophic changes.
I. - Dyspepsia Secondary to Organic Disease. When we consider the stomach the great sympathetic organ of the body, whose functions are disturbed by disease which attacks the important viscera of the body, we can readily understand that this forms an important class from an etiological standpoint. Hence it can be seen that no logical opinion can be expressed as to the cause of dyspepsia in the aged, or in fact any subject unless the important organs of the body are examined, and their various functions tested as carefully as those of the stomach itself. The important organs that demand attention are those of the lungs, heart and kidneys.
Of the lung diseases producing gastric symptoms in the aged those of emphysema, chronic bronchitis with its asthmatic seizures, bronchiestasis, empyema, interstitial pneumonia, fibrotic change, or if you please, fibroid phthisis, are the important ones to consider, in fact phthisis may show many varieties of dyspepsia. The gastric symptoms are usually those analogous to a chronic gastritis in their nature and manifestation, and the result of dilatation of the right side of the heart, inducing a passive congestion of the stomach, while in other types, the result of the constant absorption of toxic materials from the diseased lungs.
The role of cardiac disease should not be underestimated. In uncomplicated valvular disease, the functions of the stomach are not markedly disturbed, but when dilatation occurs, passive congestion involving the portal system ensues, and the stomach suffers in consequence of same, even at times to the point of impaired motility. Even when compensation is complete the subjects of valvular disease often experience annoying digestive disturbances.
The symptoms of note include oppression and flatulence after meals, distention producing attacks of palpitation, dizziness and at times syncope. Vomiting ensues and may be persistent, the vomited matter consisting of bile, stained mucus and occasionally blood.
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