ROSH Gastrointestinal Practice Exam

In the context of gastrointestinal complaints, what is a potential sign of a significant underlying pathology in the elderly?

1. Diarrhea

2. Constipation

3. Unintentional weight loss

4. Abdominal cramping

The correct answer is: Unintentional weight loss

Unintentional weight loss is a significant sign of potential underlying pathology in the elderly, particularly in the context of gastrointestinal complaints. In this age group, weight loss can indicate various serious conditions including malignancies, malnutrition, metabolic disorders, or chronic illnesses. Given that older individuals often have multiple comorbidities, unexpected changes in weight serve as an essential red flag indicating a need for further investigation and potentially a more serious diagnosis. In contrast, while diarrhea, constipation, and abdominal cramping can certainly impact an elderly person's quality of life and might indicate gastrointestinal issues, they are not as strongly associated with severe underlying conditions as unintentional weight loss. Diarrhea and constipation can be caused by many benign factors including dietary changes or medication side effects. Similarly, abdominal cramping might result from less serious causes, such as food intolerances or minor gastrointestinal disturbances. Therefore, unintentional weight loss stands out as a more alarming symptom that warrants immediate clinical attention.