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KMID : 0978920120130040015
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Korean Journal of Clinical Geriatrics
2012 Volume.13 No. 4 p.15 ~ p.157
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Gastroesophageal Reflux Disease in Older Patients
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Cho Yong-Jin
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Abstract
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Above-Westernization of dietary habits and the aging of the population, gastroesophageal reflux disease is a very common disease, and an increased incidence in Korea. This occurs due to insufficient esophageal clearance, weakend mucosal resistance and delayed gastric emptying. Especially in the elderly, abnormal peristalsis of the esophagus and dysfunction of production of saliva affects esophageal clearance, this cause esophageal mucosal damage. In the elderly can be taking many kinds of medication, clinician need to check history of medication. Clinical symptoms in elderly patients compared to younger patients, symptoms such as heartburn less frequntly expressed but dysphagia may occur more frequently. If elderly patients complain about heartburn, upper GI endoscopy recommended for initial work-up, or patients have symptom of dysphagia, clinician consider barium fluoroscopy. If patients do not respond to the drug, doctor can take 24-hour esophageal pH monitoring into account but because of invasiveness of 24-hour esophageal pH monitoring, it can not be considerate 1st recommendation. In the treatment of the elderly, it follows the general principle of the treatment of the GERD, however, GERD of the elderly can involve complications, often the treatment of the elderly need to be much more aggressive drug therapy for symptoms relief and healing of esophageal lesions. Treatment include lifestyle changes, H2 receptor blockers, prokinetics, proton-pump inhibitor, and surgical treatment. Complications such as ulceration, stricture, and Barrett’s esophagus, they need to appropriate treatment.
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KEYWORD
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GERD, Gastroesophageal reflux disease, The elderly
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