Gastroesophageal reflux disease (GERD) is common in adults of all ages, but its complications are more frequent in elderly patients.
Heartburn is the most common symptom of GERD. However, it is not clear whether the severity of heartburn indicates the severity of erosive esophagitis.
|Severe heartburn was less frequent in the older age groups.|
In this study, physicians assessed the relationship between age, severe heartburn symptoms, and severe erosive esophagitis.
The team pooled data from 5 clinical trials that assessed the effect of proton pump inhibitors on healing of erosive esophagitis and symptom resolution.
The trials were conducted in 683 centers and involved 11,945 adults with GERD and erosive esophagitis.
The team identified a progressive increase in the prevalence of severe erosive esophagitis with each decade of age. This ranged from 12% in patients under 21 years to 37% in patients aged over 70 years.
In patients with severe esophagitis, severe heartburn was less frequent in the older age groups. Severe heartburn occurred in 82% of patients aged less than 21 years versus 34% on those aged over 70.
Drs David Johnson and Brian Fennerty concluded, "Although the prevalence of severe erosive esophagitis increases with age, the severity of heartburn is an unreliable indicator of the severity of erosive disease."
"More aggressive investigation and treatment may be necessary for elderly patients, regardless of the reported severity of heartburn."