Elderly Patients May Require More Aggressive GERD Treatment

Symptoms of gastroesophageal reflux disease (GERD) occur as commonly in older adults (55?74 years) as in the general adult population?up to 20% of older adults suffer from GERD. Erosive esophagitis and other GERD complications, however, occur more frequently in older adults.

In a study published in the March 2004 issue of Gastroenterology, David A. Johnson, MD, and M. Brian Fennerty, MD, analyzed baseline data from 5 prospective, randomized, controlled clinical trials that were conducted in 683 academic and private offices and involved 11,945 patients. Researchers evaluated the relationships among age, heartburn severity, and erosive esophagitis severity in adults of all ages. Results showed a progressive increase in the prevalence of severe erosive esophagitis with each decade of age, ranging from 12% in patients younger than 21 years of age to 37% in patients older than 70 years of age. Severe heartburn, however, was reported less frequently among older patients with severe erosive esophagitis (>70 years, 34%) than among younger patients with the disorder (<21 years, 82%).

The authors concluded that severity of heartburn is an unreliable indicator of erosive disease severity. They stated that more aggressive investigation and treatment may be appropriate for older patients, regardless of reported heartburn severity.