Effects of age on the gastroesophageal junction, esophageal motility, and reflux disease.

Effects of age on the gastroesophageal junction, esophageal motility, and reflux disease. Research Abstract Details 

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Effects of age on the gastroesophageal junction, esophageal motility, and reflux disease. Abstract Text:

Jacqueline Lee,Angela Anggiansah,Roy Anggiansah,Alasdair Young,Terry Wong,Mark Fox,Jacqueline Lee,Angela Anggiansah,Roy Anggiansah,Alasdair Young,Terry Wong,Mark Fox,

BACKGROUND & AIMS: The prevalence of complicated gastroesophageal reflux disease (GERD) increases with age; however, the mechanism by which this occurs is uncertain. This study assessed (1) whether physiologic degradation of the gastroesophageal junction and esophageal motility occurs with aging, and (2) whether these effects are associated with increased esophageal acid exposure and reflux symptoms in the elderly. METHODS: Retrospective study of 1307 patients referred for investigations of reflux symptoms (median age, 49 years; range, 15-92 years) was conducted. Manometry assessed LES pressure, LES length, and esophageal peristalsis. Ambulatory pH studies assessed esophageal acid exposure (% time pH <4) during a period of 24 hours; reflux symptoms were assessed by validated questionnaire. RESULTS: On multivariate regression, esophageal acid exposure was associated independently with decreasing LES pressure (P < .0001) and abdominal LES length (P < .0004). Dysmotility exacerbated reflux in the recumbent position (P < .004). Acid exposure increased with age (P < .0001), a 1.1%/24 hours (95% confidence interval, 0.4%-1.4%) increase in acid exposure every decade (more pronounced in the recumbent position). The age-related increase in acid exposure was associated independently with decreasing abdominal LES length (P < .001) and increasing dysmotility (P < 0.01). Reflux symptoms increased with acid exposure (P < .001); however, at any given level of exposure, symptom severity was less in the elderly (P < .006). CONCLUSIONS: Age was associated with an increase in esophageal acid exposure; however, the severity of reflux symptoms reduced with age. These changes were associated with progressive decrease in abdominal LES length and esophageal motility. Increasing GERD severity in the elderly is related to degradation of the gastroesophageal junction and impaired esophageal clearance.

Effects of age on the gastroesophageal junction, esophageal motility, and reflux disease. Publishing Authors By Initials

J Lee,A Anggiansah,R Anggiansah,A Young,T Wong,M Fox,J Lee,A Anggiansah,R Anggiansah,A Young,T Wong,M Fox,

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Effects of age on the gastroesophageal junction, esophageal motility, and reflux disease. Journal Published:

PUBLICATION TYPE: Research Support, Non-U.S. Gov

Journal: Clinical gastroenterology and hepatology : the off

VOLUME: 5

Page Numbers: 1392-8

Journal Abbreviation: Clin. Gastroenterol. Hepatol.

ISSN: 1542-7714

DAY: 1

MONTH: 11

YEAR: 2007

Effects of age on the gastroesophageal junction, esophageal motility, and reflux disease. Information

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LANGUAGE: eng

NlmUniqueID: 101160775

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Grant and Affiliation Information for Effects of age on the gastroesophageal junction, esophageal motility, and reflux disease.

AFFILIATION: Department of Gastroenterology, Guy's and St. Thomas' Hospital, London, United Kingdom.

Country: United States

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MEDLINETA: Clin Gastroenterol Hepatol

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