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Heartburn May Not Reflect Gastroesophageal Reflux Disease Severity
      03/30/04 02:43 PM
HeatherAdministrator

Reged: 12/09/02
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Heartburn May Not Reflect Gastroesophageal Reflux Disease Severity

Mar 12 - Particularly in the elderly, the severity of heartburn may not reflect the severity of erosive gastroesophageal reflux disease, according to a report in the March issue of Gastroenterology.

"Gastroesophageal reflux disease is common in adults of all ages, but its complications are more frequent in elderly patients," Dr. David A. Johnson, of Eastern Virginia Medical School, in Norfolk and Dr. Brian Fennerty of Oregon Health Sciences University, Portland, point out.

To investigate further, the researchers examined the relationship of age, severe heartburn symptoms, and severe erosive esophagitis. The team pooled data from five prospective, randomized, controlled trials that examined the effect of proton pump inhibitors on healing of erosive esophagitis and symptom resolution. Involved in the study were 11,945 patients with gastroesophageal reflux disease and erosive esophagitis.

The investigators observed a progressive increase in the prevalence of severe erosive esophagitis with each decade of age. In patients younger than 21 years, only 12% had severe esophagitis at baseline, compared with 37% of those older than 70 years.

Severe heartburn was present in more than 50% of patients younger than 50 years with severe esophagitis. However, severe heartburn was less common in older patients with severe esophagitis and was least likely to be found in those older than 70 years.

Given these findings, the investigators call for more aggressive diagnosis and treatment of elderly patients, "regardless of the reported severity of their presenting symptoms."

Gastroenterology 2004;126:660-664.

http://www.medscape.com/viewarticle/471671?mpid=26286

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