The prevalence of upper gastrointestinal (GI) diseases is
increasing in subjects aged 65 years and over. Pathophysiological
changes in esophageal functions that occur with aging may, at least in
part, be responsible for the high prevalence of
1. Gastro-esophageal reflux disease (GERD) in old age.
2. The incidence of gastric and duodenal ulcers and their bleeding complications is increasing in old-aged populations worldwide.
3. H. pylori infection in elderly patients with H. pylori-associated peptic ulcer disease and severe chronic gastritis
4. Almost 40% of GU and 25% of DU in the elderly patients are associated with the use of NSAID(1) and/or aspirin(2).(a)
I. Gastro-esophageal reflux disease (GERD)
Gastroesophageal
reflux disease (GERD), also known as gastro-oesophageal reflux
disease (GORD), gastric reflux disease, or acid reflux disease, is
defined as a chronic condition of liquid stomach acid refluxing back
up from the stomach into the esophagus, causing heartburn. According
to the study of “Updated guidelines for the diagnosis and treatment
of gastroesophageal reflux disease.” by DeVault KR, Castell DO;
American College of Gastroenterology, GERD is defined as symptoms or
mucosal damage produced by the abnormal reflux of gastric contents
into the esophagus.
Causes
1. Slower in emptying of the stomach after eating
Most
uncommon causes of Gastroesophageal reflux disease (GERD) is due to
the distention of the stomach with food over prolonged period of time
that can lead to reflux. Approximately 20% of Gastroesophageal reflux
disease (GERD) are caused the reason above.
2. Cardia
Cardia is the area between the part of the stomach and
the esophagus. It is angle where the esophagus enters the stomach and
acts as a valve to prevent foods and others to reflux back to the
esophagus. If the cardia is not functioning well, it can cause
Gastroesophageal reflux disease (GERD with burning sensation of the
esophagus.
3. Esophageal contractile defection
If the esophageal contraction
fails to performed its function of proper swallowing food, it may not
generate enough waves of contractions to push the foods down to the
stomach after swallowing and the acid back into the stomach.
4. Hiatal hernia
Hiatal hernia is a condition of a portion of the stomach protrudes upward into the chest, through a tear or weakness in the diaphragm.
According to the study of Nocturnal Reflux Episodes Following the
Administration of a Standardized Meal. Does Timing Matter?Michael
Piesman, M.D.; Inku Hwang, M.D.; Corinne Maydonovitch, B.S.; Roy K.H.
Wong, M.D, posted in Medscape news Today, researchers found that GERD
patients consuming a late-evening meal had significantly greater supine
acid reflux compared to when they consumed an early meal, especially
in overweight patients, and in patients with esophagitis or HH. These findings support the recommendations to our GERD patients to eat dinner early and to lose weight.
5. Obesity
Obesity increase the risk of Gastroesophageal reflux disease (GERD). In a sudy of “The
association between gastroesophageal reflux disease and obesity.” by
Friedenberg FK, Xanthopoulos M, Foster GD, Richter JE., the authors
wrote that weight loss, through caloric restriction and behavioral
modification, has been studied infrequently as a means of improving
reflux. Bariatric surgery and its effects on a number of
obesity-related disorders have been studied more extensively. Roux-en-Y
gastric bypass (RYGB) has been consistently associated with
improvement in the symptoms and findings of GERD.
6. Esophageal mucosa
In a study of “Halimeter
ppb Levels as the Predictor of Erosive Gastroesophageal Reflux
Disease.” by Kim JG, Kim YJ, Yoo SH, Lee SJ, Chung JW, Kim MH, Park
DK, Hahm KB. posted in US National Library of Medicine
National Institutes of Health, researchers found that Erosive changes
in the esophageal mucosa were strongly associated with VSC levels,
supporting the hypothesis that halitosis can be a potential biomarker
for the discrimination between ERD and NERD, reflecting the presence
of erosive change in the lower esophagogastric junction.
7. Medication
The use of medication such as prednisolone acetate
ophthalmic suspension, an adrenocortical steroid product can increase
the risk of Gastroesophageal reflux disease (GERD).
8. Chronic diseases
Chronic diseases, including cough, pulmonary fibrosis, earache, and asthma are also associated with the higher risk of develop Gastroesophageal reflux disease (GERD)
9. Infection
Infection caused by H. pylori can
increase the risk of Gastroesophageal reflux disease (GERD). According
to the study of “Helicobacter pylori infection and chronic gastric acid
hyposecretion” by EM El-Omar, K Oien, A El-Nujumi, D Gillen, A Wirz, S
Dahill, C Williams, JE Ardill, KE McColl posted in Gastroenterology,
researchers concluded that in some subjects, chronic H. pylori
infection produces a body-predominant gastritis and profound
suppression of gastric acid secretion that is partially reversible
with eradication therapy. (Gastroenterology 1997 Jul;113(1):15-24).
10. Etc.
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Sources
(a) http://www.ncbi.nlm.nih.gov/pubmed/15588798
(1) http://www.ncbi.nlm.nih.gov/pubmed/16001646
(2) http://www.ncbi.nlm.nih.gov/pubmed/22542157
Health Researcher and Article Writer. Expert in Health Benefits of Foods, Herbs, and Phytochemicals. Master in Mathematics & Nutrition and BA in World Literature and Literary criticism. All articles written by Kyle J. Norton are for information & education only.
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