Recent Advances in the Treatment of Gerd in the Elderly: Focus on Proton Pump inhibitors

A. Pilotto; M. Franceschi; F. Paris

Disclosures

Int J Clin Pract. 2005;59(10):1204-1209. 

In This Article

Summary and Introduction

The prevalence of gastroesophageal reflux disease (GERD) increases with age, and older people are more likely to develop severe disease. Studies of elderly patients with GERD indicate differences in presentation and diagnosis, compared with GERD in younger adults. Indeed, an older patient with GERD may present with atypical symptoms such as dysphagia, vomiting, weight loss, anaemia and anorexia, and less frequently with typical symptoms such as heartburn or acid regurgitation. These findings are attributed to pathophysiological changes in esophageal function that occur with age. Therefore, GERD in elderly patients is more likely to be poorly diagnosed or undiagnosed.

Although few studies have concentrated specifically on elderly patients, the proton pump inhibitors (PPIs) have been shown to be more effective than histamine receptor antagonists for healing reflux esophagitis and for preventing its recurrence when they are given as maintenance therapy. In addition, the PPIs seem to be safe both in short- and in long-term therapy of elderly patients with GERD.

The goals of treatment for gastroesophageal reflux disease (GERD) in the elderly are essentially the same as those for other age groups. They are as follows: (i) to alleviate symptoms, (ii) heal esophagitis if present, (iii) maintain remission of the disease, and (iv) manage any complications. A number of options are currently available, including lifestyle and dietary modifications, medications and surgery; however, until now, there have been few studies carried out in elderly populations. This review focuses on the clinical aspects, the diagnosis and the treatments of GERD in elderly patients.

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