| Gerd and The Elderly |
| Written by Andrew Clac | |
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Gastroesophageal reflux disease is never a pleasant experience, but its symptoms are particularly harsh for elderly patients and the disease can result in other life-threatening illnesses.
GERD is a recurring illness that occurs when stomach acid or bile refluxes into your esophagus, irritating the lining of the esophagus and causing painful and uncomfortable symptoms. GERD is different from ordinary heartburn, in that it occurs frequently enough to have a signifciant negative impact on sufferers' lives. It's probably the most prolific upper gastrointestinal illness, impacting millions of Americans. The disease is very common among elderly patients, and while they complain less of heartburn than other GERD sufferers, elderly patients often have more severe cases of GERD and are more likely to develop life-threatening complications from the illness. As stated before GERD is very common in the elderly. In fact, nearly two-thirds of people over the age of 65 will develop GERD. The main cause of GERD is a weakness or malfunction of the esophaegal sphincter, which basically separates your food pipe from your digestive tract. When this valve is weakened or is not working properly, stomach acid or bile can reflux into the esophagus, irritating the lining. Elderly people are susceptible to GERD because age can weaken the esophaegal sphincter. Other consequences of advanced age that can also contribute to GERD include: loss of esophageal sphincter tone, reduced saliva production, increased production of stomach acid and delayed gastric emptying. The symptoms of GERD in the elderly may be at first taken for the symptoms of other conditions or illnesses such as cardiac, viral or inflammatory problems because GERD manifests itself in elderly people a little differently than it does in younger patients. In the elderly, common symptoms of GERD such as heartburn, chest pain and regurgitation are less prevalent. Instead, symptoms of GERD in the elderly include more severe symptoms such as frequent vomiting, respiratory symptoms and dysphagia. There's also a number of illnesses and conditions common to the elderly that can contribute to GERD. Parkinson's disease can affect the nerves that guide muscles in the gastrointestinal tract, resulting in reflux . Hypertension, obesity and coronary artery disease can also contribute to GERD. Medications that many elderly people regularly take can also contribute to GERD. NSAIDs enzyme-blocking properties can result in problems that lead up to GERD. Potassium cholride tablets can cause relaxation of the esophageal sphincter. Elderly people who take iron supplements are at increased risk for GERD because these supplements can also cause a relaxation of the esophageal sphincter, and thus contribute to GERD. Nearly a fifth of all elderly GERD patients report other complications. Some common complications of GERD include Barrett's esophagus, a change in the color and composition of the lower esophagus; esophageal cancer and pulmonary aspiration, an entry of foreign material and secretions into the lungs and trachea. One of the first lines of treatment of GERD in elderly patients is changing lifestyle or eating habits. This can be particularly difficult with elderly patients, because in many cases, health care providers are asking the patient to change behaviors or lifestyle choices which have been practiced for decades or even a whole lifetime. Addictive behaviors that contribute to GERD, such as smoking or alcohol consumption, are particularly difficult to change. However, the modification of behavior and lifestyle can greatly mitigate the impact of GERD on seniors and improve their overall health. The next phase of treatment in elderly patients is medication. When treating GERD in the elderly, doctors have found that proton-pump inhibitors are a very effective, non-invasive means of handling the illness. Proton-pump inhibitors work to reduce the production of stomach acid, thus lessening the negative impact of a weakened esophaegal sphincter. If medication does not suffice, health care professionals may also choose to perform surgery to alleviate the condition. The laparoscopic Nissen fundoplication is perhaps the most commonly used surgical application for treating GERD. In this form of surgery, part of the stomach and esophagus are wrapped together to shore up the esophaegal sphincter. This form of surgery has proven very effective and a relatively small number of patients report any recurrence of GERD after the surgery. Health care providers are sometimes reluctant to perform surgery on the elderly, and rightfully so, as many elderly patients are at advanced risk for complications as a result of surgery. Before surgery is performed, elderly patients and their doctors should do a thorough risk analysis to determine if any other conditions or illnesses and treatments or medications might pose an undue surgical risk. |
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