Efecto del envejecimiento en el estudio y manejo de la enfermedad por reflujo gastroesofágico
Effect of aging on the study and management of Gastroesophageal Reflux Disease
Gastroenterol. latinoam; 30 (supl.1), 2019
Publication year: 2019
The prevalence of Gastroesophageal Reflux Disease (GERD) seems to increase in the elderly population,
being more severe and associating more complications than younger subjects. A high frequency of atypical
symptoms (chest pain, dysphagia, vomiting, and respiratory symptoms) and less frequently heartburn and
/ or regurgitation that are of mild intensity are described, due to the decrease of the visceral sensitivity of
the esophagus with age, which delays the diagnosis.
Factors associated with aging predispose to the development of GERD in the geriatric population:
the reduction of salivary flow and bicarbonate secretion, alterations in esophageal motility and the greater frequency of hiatal hernias are some of them. Given the high frequency of complications of reflux (erosive esophagitis, Barrett’s esophagus, stenosis and ulcers, and esophageal cancer), elderly patients benefit from an early endoscopic study. Its management must be aggressive and start with changes in lifestyle and dietary modifications. Proton pump inhibitors (PPIs) continue to be the first line of pharmacological treatment as well as in the youngest population. Surgical treatment is reserved in selected patients considering risks/benefits.
La prevalencia de la enfermedad por reflujo gastroesofágico (ERGE) parece aumentar en la población
adulto mayor, siendo más severa y asociando más complicaciones que en los sujetos más jóvenes. Clínicamente se caracteriza una alta frecuencia de síntomas atípicos (dolor torácico, disfagia, vómitos, síntomas
respiratorios) y menos frecuentemente por pirosis y/o regurgitación que son de leve intensidad, debido
a la disminución de la sensibilidad visceral del esófago con la edad, lo que hace retardar el diagnóstico.