Second Department of Internal Medicine, Shimane University, 89-1 Enya-cho, Izumo, Shimane 693-8501, Japan.
J Gastroenterol. 2012 Feb;47(2):144-9. doi: 10.1007/s00535-011-0476-9. Epub 2011 Oct 8.
The characteristics of symptoms reported by elderly patients with gastroesophageal reflux disease (GERD) have not been fully investigated. We performed this study to clarify these characteristics in elderly patients with GERD.
The study subjects were 340 Japanese patients with symptoms of heartburn and/or acid regurgitation. All patients were investigated by upper gastrointestinal endoscopy, and were asked about the presence of atypical GERD symptoms, such as an epigastric burning sensation, epigastralgia, epigastric discomfort, and abdominal fullness, as well as the time of day when bothersome symptoms occurred.
Of the 340 patients, 161 were elderly (≥65 years old) and 179 were non-elderly (age <65 years). There were 158 patients without esophageal mucosal breaks, 147 with low-grade reflux esophagitis (RE; Los Angeles classification grade A or B), and 35 with high-grade reflux esophagitis (LA grade C or D). Elderly patients with RE reported typical reflux symptoms at the same frequency as the non-elderly patients, whereas elderly patients without mucosal breaks reported typical symptoms more frequently than the non-elderly patients without mucosal breaks. Both elderly and non-elderly patients with different types of GERD reported that their symptoms occurred most frequently during the postprandial period.
Elderly patients with GERD tend to show typical GERD symptoms frequently at the typical post-prandial time points in a day, irrespective of the presence of esophageal mucosal breaks.
老年人胃食管反流病(GERD)患者报告的症状特征尚未得到充分研究。我们进行了这项研究,以阐明老年 GERD 患者的这些特征。
研究对象为 340 名有烧心和/或反酸症状的日本患者。所有患者均接受上消化道内镜检查,并询问有无非典型 GERD 症状,如上腹部烧灼感、上腹痛、上腹部不适和腹胀,以及症状发作的时间。
340 名患者中,161 名为老年人(≥65 岁),179 名为非老年人(年龄<65 岁)。158 名患者无食管黏膜破损,147 名患者为低级别反流性食管炎(RE;洛杉矶分级 A 或 B),35 名患者为高级别反流性食管炎(LA 分级 C 或 D)。RE 的老年患者与非老年患者报告典型反流症状的频率相同,而无黏膜破损的老年患者比无黏膜破损的非老年患者更常报告典型症状。不同类型 GERD 的老年和非老年患者均报告其症状最常发生在餐后。
不论是否存在食管黏膜破损,老年 GERD 患者往往在一天中典型的餐后时间点频繁出现典型的 GERD 症状。