By A. M. Gelb, B. Straus (auth.), Professor Dr. med. Dieter Platt (eds.)

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Extra resources for Geriatrics 2: Digestive System · Endocrine System Kidney and Urogenital System Haematological System · Respiratory System Rehabilitation · Nutrition · Drug Treatment

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Am J Gastroenterol 69:253-271" Brandborg LL (1978 a) Polyps, tumors, cancer of the stomach. In: Sleisenger MH, Fordtran JS (eds) Gastrointestinal disease, 2nd edn. WB Saunders Co, Philadelphia London Toronto, p 752 Brandborg LL (1978 b) Other infectious, inflammatory, and miscellaneous diseases. In: Sleisenger MH, Fordtran JS (eds) Gastrointestinal disease, 2nd edn. WB Saunders Co, Philadelphia London Toronto, p 1010 Bryk D, Elguezabal A (1975) Roentgen problems in evaluating the atrophic stomach of the elderly.

Postoperative pancreatitis is also more common in the elderly. Other associations such as alcoholism, hyperparathyroidism, and idiopathy seem not to be age related. Since elderly patients are frequently on medication, drug-associated pancreatitis may occur. Incriminated substances that are important in elderly patients include corticosteroids, thiazide diuretics, furosemide, isoniazid, azathioprine, and anticoagulants. The clinical presentation in the elderly may be different. Silent attacks are more common, the diagnosis being made at postmortem.

Pancreatic insufficiency causes intolerance to fat, but fatty acids can be absorbed. In small bowel steatorrhea, both fat and fatty acids are not tolerated. This differential can be used both in stool analysis and in breath tests. Blood and urine levels of amylase and lipase are valuable in the diagnosis of acute pancreatitis. Since blood amylase is elevated in other conditions, attempts have been made to find a more specific measurement. The ratio of urinary amylase clearance to creatinine clearance appears to be more specific, although not absolutely so.

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