Gastroesophageal Reflux Disease in the Elderly

  • M. F. Vaezi
  • J. Swoger


Gastroesophageal reflux disease is a common condition in the elderly, and will become more prevalent as the population ages. Elderly patients often do not present with the classic symptoms of heartburn and acid regurgitation, which can delay diagnosis and contribute to the development of complications. Atypical symptoms such as chest pain, pulmonary, and laryngeal symptoms are more common in this group, and reflux should be considered early in the work-up if these symptoms are present. Due to an increase in complications of reflux disease in this population, most elderly patients being evaluated for reflux symptoms should have an upper endoscopy early in the diagnostic process. There are some important age related changes in the esophagus, including decreased secondary peristalsis, decreased salivary secretion, and an increased visceral pain threshold. However, many age-related changes to motility are not thought to be clinically relevant. More aggressive treatment of reflux disease may be required in the elderly population, as they are more likely to present with complicated disease, despite less severe symptoms. Age alone does not significantly impact the usage of PPI’s, and these medications have excellent results in the elderly for symptom relief, healing of esophagitis, and for maintenance therapy. With the advent of laparoscopic surgery, and an increasing life expectancy, this treatment may become more common in the elderly population, as it is associated with excellent results as well as low morbidity and mortality.


Lower Esophageal Sphincter Atrophic Gastritis GERD Symptom Erosive Esophagitis Lower Esophageal Sphincter Pressure 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


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© Springer-Verlag/Wien 2006

Authors and Affiliations

  • M. F. Vaezi
    • 1
  • J. Swoger
    • 1
  1. 1.Department of Gastroenterology and Hepatology, Center for Swallowing and Esophageal DisordersCleveland Clinic FoundationUSA

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