Tags

Type your tag names separated by a space and hit enter

Long-term gastroesophageal reflux disease therapy improves reflux symptoms in elderly patients: five-year prospective study in community medicine.
J Gastroenterol Hepatol. 2007 May; 22(5):639-44.JG

Abstract

BACKGROUND

Gastroesophageal reflux disease (GERD) impairs the patient's quality of life (QOL), but the effect of long-term maintenance therapy in elderly patients is unknown.

METHODS

We conducted a long-term prospective study. Forty-four GERD patients (11 males; mean age 74 years; QUEST score of at least 6 points) were enrolled in this study. Step-down therapy was selected (proton-pump inhibitor [PPI], histamine-2 receptor antagonist and prokinetic agents for 1 month, respectively). Optimal medication for each patient was continued for 5 years. The efficacy, safety of treatment and reflux symptoms were analyzed. The profiles of the patients who had to continue PPI maintenance therapy were also analyzed.

RESULTS

Reflux symptoms were reduced by the PPI based step-down therapy (baseline 13.8 times/month, after 3.2 times/month, P < 0.001). Reflux symptoms improved in 34 patients (77%). None of the 44 patients had to cease treatment because of side-effects and none experienced any complications during the 5-year period. The prevalence of Helicobacter pylori (Hp) infection in the PPI group (29%, 4/14) was significantly lower (P < 0.01) than in the other treatment group (72%, 21/29). The serum pepsinogen I/II ratio in the PPI treatment group (5.7 +/- 0.5) was significantly higher (P < 0.01) than in the others (4.0 +/- 0.3). The predictive factors for PPI maintenance therapy were Hp-negative status and serum pepsinogen I/II ratio >6.0 (odds ratio 12.0, 95% confidence interval 2.7-54.2).

CONCLUSIONS

Long-term medication for GERD selected on the basis of the patient's profile (i.e. Hp status and gastric atrophy) improved reflux symptoms.

Authors+Show Affiliations

Department of General Internal Medicine, Prefectural Hiroshima Hospital, Hiroshima, Japan.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Clinical Trial
Journal Article

Language

eng

PubMed ID

17444849

Citation

Miyamoto, Masaki, et al. "Long-term Gastroesophageal Reflux Disease Therapy Improves Reflux Symptoms in Elderly Patients: Five-year Prospective Study in Community Medicine." Journal of Gastroenterology and Hepatology, vol. 22, no. 5, 2007, pp. 639-44.
Miyamoto M, Haruma K, Kuwabara M, et al. Long-term gastroesophageal reflux disease therapy improves reflux symptoms in elderly patients: five-year prospective study in community medicine. J Gastroenterol Hepatol. 2007;22(5):639-44.
Miyamoto, M., Haruma, K., Kuwabara, M., Nagano, M., Okamoto, T., & Tanaka, M. (2007). Long-term gastroesophageal reflux disease therapy improves reflux symptoms in elderly patients: five-year prospective study in community medicine. Journal of Gastroenterology and Hepatology, 22(5), 639-44.
Miyamoto M, et al. Long-term Gastroesophageal Reflux Disease Therapy Improves Reflux Symptoms in Elderly Patients: Five-year Prospective Study in Community Medicine. J Gastroenterol Hepatol. 2007;22(5):639-44. PubMed PMID: 17444849.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Long-term gastroesophageal reflux disease therapy improves reflux symptoms in elderly patients: five-year prospective study in community medicine. AU - Miyamoto,Masaki, AU - Haruma,Ken, AU - Kuwabara,Masao, AU - Nagano,Makoto, AU - Okamoto,Takeshi, AU - Tanaka,Mio, PY - 2007/4/21/pubmed PY - 2007/7/18/medline PY - 2007/4/21/entrez SP - 639 EP - 44 JF - Journal of gastroenterology and hepatology JO - J Gastroenterol Hepatol VL - 22 IS - 5 N2 - BACKGROUND: Gastroesophageal reflux disease (GERD) impairs the patient's quality of life (QOL), but the effect of long-term maintenance therapy in elderly patients is unknown. METHODS: We conducted a long-term prospective study. Forty-four GERD patients (11 males; mean age 74 years; QUEST score of at least 6 points) were enrolled in this study. Step-down therapy was selected (proton-pump inhibitor [PPI], histamine-2 receptor antagonist and prokinetic agents for 1 month, respectively). Optimal medication for each patient was continued for 5 years. The efficacy, safety of treatment and reflux symptoms were analyzed. The profiles of the patients who had to continue PPI maintenance therapy were also analyzed. RESULTS: Reflux symptoms were reduced by the PPI based step-down therapy (baseline 13.8 times/month, after 3.2 times/month, P < 0.001). Reflux symptoms improved in 34 patients (77%). None of the 44 patients had to cease treatment because of side-effects and none experienced any complications during the 5-year period. The prevalence of Helicobacter pylori (Hp) infection in the PPI group (29%, 4/14) was significantly lower (P < 0.01) than in the other treatment group (72%, 21/29). The serum pepsinogen I/II ratio in the PPI treatment group (5.7 +/- 0.5) was significantly higher (P < 0.01) than in the others (4.0 +/- 0.3). The predictive factors for PPI maintenance therapy were Hp-negative status and serum pepsinogen I/II ratio >6.0 (odds ratio 12.0, 95% confidence interval 2.7-54.2). CONCLUSIONS: Long-term medication for GERD selected on the basis of the patient's profile (i.e. Hp status and gastric atrophy) improved reflux symptoms. SN - 0815-9319 UR - https://www.unboundmedicine.com/medline/citation/17444849/Long_term_gastroesophageal_reflux_disease_therapy_improves_reflux_symptoms_in_elderly_patients:_five_year_prospective_study_in_community_medicine_ L2 - https://doi.org/10.1111/j.1440-1746.2007.04871.x DB - PRIME DP - Unbound Medicine ER -