Mullick T, Richter J E
Department of Gastroenterology, Cleveland Clinic Foundation, OH, USA.
Geriatrics. 2000 Nov;55(11):28-30, 33-4, 37-9 passim.
Gastroesophageal reflux disease (GERD) is a common chronic disease in the older population. Because of the cumulative effects of acid reflux over many years, older patients with GERD are at increased risk of complications such as esophagitis, peptic strictures, and Barrett's esophagus. Early endoscopy is indicated for all older patients with GERD, irrespective of their symptoms. Medical and surgical treatment options for GERD and its complications can provide excellent symptom relief and healing of esophagitis. Three management approaches--step up, step down, and the directed approach--are recognized guides to clinical decision-making.
胃食管反流病（GERD）是老年人群中的一种常见慢性病。由于多年来胃酸反流的累积效应，老年GERD患者发生食管炎、消化性狭窄和巴雷特食管等并发症的风险增加。所有老年GERD患者均需早期进行内镜检查，无论其症状如何。GERD及其并发症的药物和手术治疗方案可有效缓解症状并治愈食管炎。三种管理方法——逐步升级、逐步降级和定向治疗方法——是临床决策的公认指南。
