Comparison Of Clinical Features Between Elderly And Non-elderly Patients With Gastroesophageal Reflux Disease

Objective:This study mainly investigated the clinical characteristics of elderly patients with gastroesophageal reflux disease and their differences from non-elderly patients.Methods:A retrospective analysis was made on 804 patients diagnosed as GERD in the Department of Gastroenterology,China-Japan Friendship Hospital of Jilin University from January 2018 to January 2021.The GERD patients were divided into elderly group(≥65 years old)and non-elderly group(<65 years old).All the clinical data of the patients were collected and the differences of clinical characteristics between the two groups were compared.Results:(1)Typical symptoms in elderly patients with GERD are less than those in non-elderly patients,while non-typical symptoms are more common;The GERD-Q score and the quality of life score in elderly patients were lower than those in non-elderly patients.(2)The effective proportion of GERD patients treated with PPI test in the aged group is lower than that in the non-aged group,and the proportion of refractory GERD in the aged group is higher than that in the non-aged group.(3)The C and D grades of endoscopic esophagitis in GERD patients in the elderly group were more common than those in the non-elderly group;(4)The frequency of reflux times in elderly patients with GERD was significantly higher than that in non-elderly patients;(5)The incidence of ineffective esophageal peristalsis in elderly patients with GERD is significantly higher than that in non-elderly group;(6)Univariate analysis showed that BMI of refractory GERD patients was lower than that of non-refractory GERD patients,and the age of refractory GERD patients was older than that of non-refractory GERD patients.Multivariate Logistic regression analysis showed that refractory GERD was correlated with BMI and age,and elderly patients with low BMI had worse response to PPI treatment.Conclusions:(1)Typical symptoms are less common in elderly patients with GERD than in nonelderly patients,whereas atypical symptoms are more common.(2)Elderly patients with GERD have a more severe degree of endoscopic esophagitis,diminished esophageal motility in elderly patients,and a higher incidence of reflux events in elderly patients.(3)The incidence of GERD is higher in the elderly with refractory GERD;Refractory GERD is associated with BMI,age,in which older patients have a worse response to PPI treatment,and a lower BMI is negatively correlated with PPI efficacy.