gastroesophageal reflux disease (GERD) in the elderly

Pathology

• incompetence of lower esophageal sphincter is more common in the elderly
• the elderly more frequently take medications that diminish lower esophageal sphincter pressure
• diminished saliva production in the elderly
• esophageal motility more often impaired in elderly
  • Parkinson's disease
  • cerebrovascular disease
  • diabetes mellitus
• age-related decrease in esophageal pain perception

Clinical manifestations

• elderly less likely than younger patients to present with heartburn, epigastric pain or chest pain
• elderly may present with atypical symptoms:
  • anorexia, weight loss, vomiting

Diagnostic procedures

• see gastroesophageal reflux disease (GERD)

Complications

• complications more frequent in the elderly
• esophagitis more common in elderly
  • 81% of elderly vs 47% of younger adults*
• Barrett's esophagus more common in elderly
• dysphagia, especially with solid foods is more common in the elderly
  • may be sign of esopagheal stricture or esophageal cancer

* 47% seems high

Management

• see gastroesophageal reflux disease (GERD)

More general terms

• gastroesophageal reflux disease (GERD)
• geriatric disorder; disease of old age; geriatric syndrome