Looking at the wisdom of Donguibogam through the lens of modern medicine, we can see that senile dyspepsia is not merely an issue to brush aside as something that naturally happens with age, but the result of complex physical changes. When our stomach ingests food, peristalsis moves like waves to mix digestive enzymes and gastric acid thoroughly, pushing the food into the small intestine. This entire process takes place under the sophisticated direction of the autonomic nervous system, particularly the vagus nerve, which is the core of the parasympathetic nerve, and the enteric nervous system, the stomach's own neural network.
As we age, however, changes occur in this command system. First, the number and function of smooth muscle cells responsible for gastrointestinal motility gradually decrease, and muscle contractility also weakens. Like a worn spring losing its elasticity, this means the force with which the stomach pushes food downward diminishes. As a result, the time food remains inside the stomach lengthens, leading to bloating and causing you to feel satiety quickly even after eating small amounts. This phenomenon is called delayed gastric emptying.
Furthermore, the ability to secrete gastric acid and digestive enzymes also declines. Gastric acid is essential for sterilizing food and digesting protein, but as the function of stomach wall cells drops due to aging, hypochlorhydria, in which gastric acid secretion decreases, commonly appears. This leads to poor protein digestion and can cause issues with absorbing nutrients such as iron and vitamin B12. In addition, the activity of digestive enzymes secreted by the saliva and pancreas declines, lowering overall digestive efficiency.
Moreover, the gut microbiota environment also changes with aging. As beneficial bacteria decrease and harmful bacteria increase, they can trigger inflammatory responses in the gastrointestinal tract or disrupt the digestive process. These changes act together as the primary causes behind symptoms such as senile dyspepsia, postprandial discomfort, and decreased gastric motility. Going beyond simply relieving symptoms, understanding and addressing these fundamental changes is essential.
