Tags

Type your tag names separated by a space and hit enter

Effects of age on the gastroesophageal junction, esophageal motility, and reflux disease.
Clin Gastroenterol Hepatol 2007; 5(12):1392-8CG

Abstract

BACKGROUND & AIMS

The prevalence of complicated gastroesophageal reflux disease (GERD) increases with age; however, the mechanism by which this occurs is uncertain. This study assessed (1) whether physiologic degradation of the gastroesophageal junction and esophageal motility occurs with aging, and (2) whether these effects are associated with increased esophageal acid exposure and reflux symptoms in the elderly.

METHODS

Retrospective study of 1307 patients referred for investigations of reflux symptoms (median age, 49 years; range, 15-92 years) was conducted. Manometry assessed LES pressure, LES length, and esophageal peristalsis. Ambulatory pH studies assessed esophageal acid exposure (% time pH <4) during a period of 24 hours; reflux symptoms were assessed by validated questionnaire.

RESULTS

On multivariate regression, esophageal acid exposure was associated independently with decreasing LES pressure (P < .0001) and abdominal LES length (P < .0004). Dysmotility exacerbated reflux in the recumbent position (P < .004). Acid exposure increased with age (P < .0001), a 1.1%/24 hours (95% confidence interval, 0.4%-1.4%) increase in acid exposure every decade (more pronounced in the recumbent position). The age-related increase in acid exposure was associated independently with decreasing abdominal LES length (P < .001) and increasing dysmotility (P < 0.01). Reflux symptoms increased with acid exposure (P < .001); however, at any given level of exposure, symptom severity was less in the elderly (P < .006).

CONCLUSIONS

Age was associated with an increase in esophageal acid exposure; however, the severity of reflux symptoms reduced with age. These changes were associated with progressive decrease in abdominal LES length and esophageal motility. Increasing GERD severity in the elderly is related to degradation of the gastroesophageal junction and impaired esophageal clearance.

Authors+Show Affiliations

Department of Gastroenterology, Guy's and St. Thomas' Hospital, London, United Kingdom.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

17936081

Citation

Lee, Jacqueline, et al. "Effects of Age On the Gastroesophageal Junction, Esophageal Motility, and Reflux Disease." Clinical Gastroenterology and Hepatology : the Official Clinical Practice Journal of the American Gastroenterological Association, vol. 5, no. 12, 2007, pp. 1392-8.
Lee J, Anggiansah A, Anggiansah R, et al. Effects of age on the gastroesophageal junction, esophageal motility, and reflux disease. Clin Gastroenterol Hepatol. 2007;5(12):1392-8.
Lee, J., Anggiansah, A., Anggiansah, R., Young, A., Wong, T., & Fox, M. (2007). Effects of age on the gastroesophageal junction, esophageal motility, and reflux disease. Clinical Gastroenterology and Hepatology : the Official Clinical Practice Journal of the American Gastroenterological Association, 5(12), pp. 1392-8.
Lee J, et al. Effects of Age On the Gastroesophageal Junction, Esophageal Motility, and Reflux Disease. Clin Gastroenterol Hepatol. 2007;5(12):1392-8. PubMed PMID: 17936081.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Effects of age on the gastroesophageal junction, esophageal motility, and reflux disease. AU - Lee,Jacqueline, AU - Anggiansah,Angela, AU - Anggiansah,Roy, AU - Young,Alasdair, AU - Wong,Terry, AU - Fox,Mark, Y1 - 2007/11/01/ PY - 2007/10/16/pubmed PY - 2008/1/18/medline PY - 2007/10/16/entrez SP - 1392 EP - 8 JF - Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association JO - Clin. Gastroenterol. Hepatol. VL - 5 IS - 12 N2 - BACKGROUND & AIMS: The prevalence of complicated gastroesophageal reflux disease (GERD) increases with age; however, the mechanism by which this occurs is uncertain. This study assessed (1) whether physiologic degradation of the gastroesophageal junction and esophageal motility occurs with aging, and (2) whether these effects are associated with increased esophageal acid exposure and reflux symptoms in the elderly. METHODS: Retrospective study of 1307 patients referred for investigations of reflux symptoms (median age, 49 years; range, 15-92 years) was conducted. Manometry assessed LES pressure, LES length, and esophageal peristalsis. Ambulatory pH studies assessed esophageal acid exposure (% time pH <4) during a period of 24 hours; reflux symptoms were assessed by validated questionnaire. RESULTS: On multivariate regression, esophageal acid exposure was associated independently with decreasing LES pressure (P < .0001) and abdominal LES length (P < .0004). Dysmotility exacerbated reflux in the recumbent position (P < .004). Acid exposure increased with age (P < .0001), a 1.1%/24 hours (95% confidence interval, 0.4%-1.4%) increase in acid exposure every decade (more pronounced in the recumbent position). The age-related increase in acid exposure was associated independently with decreasing abdominal LES length (P < .001) and increasing dysmotility (P < 0.01). Reflux symptoms increased with acid exposure (P < .001); however, at any given level of exposure, symptom severity was less in the elderly (P < .006). CONCLUSIONS: Age was associated with an increase in esophageal acid exposure; however, the severity of reflux symptoms reduced with age. These changes were associated with progressive decrease in abdominal LES length and esophageal motility. Increasing GERD severity in the elderly is related to degradation of the gastroesophageal junction and impaired esophageal clearance. SN - 1542-7714 UR - https://www.unboundmedicine.com/medline/citation/17936081/Effects_of_age_on_the_gastroesophageal_junction_esophageal_motility_and_reflux_disease_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S1542-3565(07)00769-0 DB - PRIME DP - Unbound Medicine ER -