Effect of aging on esophageal motility in patients with and without GERD

Gutschow, Christian A.; Leers, Jessica M.; Schröder, Wolfgang; Prenzel, Klaus L.; Fuchs, Hans; Bollschweiler, Elfriede; Bludau, Marc; Hölscher, A. H.

doi:10.3205/000145

Cited by 13 publications

(1 citation statement)

References 25 publications

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“…If food intake is reduced due to blunted hunger signals, it could further be decreased by the post-prandial gut discomfort experienced by older adults. Indeed, gastroesophageal reflux, bloating and constipation are quite prevalent amongst adults 60 years and older ( 106 – 108 ), with esophageal motility shown to start declining as early as age 40 ( 17 , 109 ). Interventions to improve hunger in the elderly have shown to increase energy and nutrient intake and reduce age-associated weight loss.…”

Section: Key Strategies To Promote Healthy Agingmentioning

confidence: 99%

Nutritional and lifestyle management of the aging journey: A narrative review

Kassis¹,

Fichot

Horcajada

et al. 2023

Front. Nutr.

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With age, the physiological responses to occasional or regular stressors from a broad range of functions tend to change and adjust at a different pace and restoring these functions in the normal healthy range becomes increasingly challenging. Even if this natural decline is somehow unavoidable, opportunities exist to slow down and attenuate the impact of advancing age on major physiological processes which, when weakened, constitute the hallmarks of aging. This narrative review revisits the current knowledge related to the aging process and its impact on key metabolic functions including immune, digestive, nervous, musculoskeletal, and cardiovascular functions; and revisits insights into the important biological targets that could inspire effective strategies to promote healthy aging.

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Section: Key Strategies To Promote Healthy Agingmentioning

confidence: 99%

Nutritional and lifestyle management of the aging journey: A narrative review

Kassis¹,

Fichot

Horcajada

et al. 2023

Front. Nutr.

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Age-Related Differences in Clinical Characteristics and Esophageal Motility in Patients with Dysphagia

et al. 2016

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Dysphagia in elderly patients has a major effect on nutrition and quality of life (QOL). Although several studies have shown that aging itself is associated with changes in esophageal motility, the impact of these changes on dysphagia symptoms and QOL is unknown. This study assessed the manometric diagnoses of elderly patients with dysphagia compared with diagnoses in younger counterparts. Participants included 116 consecutive patients examined for dysphagia from 2007 to 2014. We divided patients into three groups by age: Group A, 66 years and older (24 men, 23 women); Group B, 45-65 years (18 men, 24 women); and Group C, 44 years and younger (15 men, 12 women). The three groups were compared in regard to symptoms, esophageal motility, and health-related QOL (HRQOL). All patients underwent esophageal manometry examination and completed a self-administered questionnaire concerning their symptoms; HRQOL assessment was based on results of the Short Form-8 General Health Survey. Symptoms rated ≥4 points on the Likert scale were defined as significant. Although all patients had dysphagia as a major symptom, more elderly patients reported globus sensation, whereas more young patients reported heartburn as the primary symptom. Manometric diagnoses were generally similar across the three groups. Ineffective esophageal motility was more prevalent in Groups A and C than in Group B, although the difference was not statistically significant. No significant differences in manometric parameters or HRQOL were detected among the three groups. Despite differences in symptom patterns, broad manometric diagnoses and impairment of HRQOL in elderly patients with dysphagia are similar to those in younger counterparts.

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Managing Esophageal Dysphagia in the Elderly

Schnoll‐Sussman

Katz

2016

Curr Treat Options Gastro

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Esophageal dysphagia in the elderly is a common clinical problem. Achalasia is a disease in which there is loss of ganglion in the myenteric plexus of the lower esophageal sphincter resulting in incomplete relaxation of that muscle causing a functional obstruction to outflow. Treatment is aimed at reducing sphincter pressure allowing for gravity and the oral portion of the swallow to propel the bolus through the esophagus. Pneumatic dilatation, Heller myotomy (laparoscopic), and the newest procedure peroral endoscopic esophageal myotomy (POEM) are all reasonable options for effective treatment even in the elderly. The choice depends on the decision of the patient, subtype of achalasia, local expertise, and fitness for surgery. Patients over 45 with type 2 achalasia respond exceptionally well to pneumatic dilation, and we recommend consideration of this technique if expertise is available. POEM has achieved excellent short-term results and if local expertise exists, it should be strongly considered especially in patients with type 3 achalasia. Type 1 achalasia may respond slightly better to myotomy, either Heller or POEM. Proton pump inhibitors remain the treatment of choice for GERD and should not be avoided in the elderly for fear of adverse reactions. While none of the FDA warnings nor concern for chronic renal failure or dementia can be dismissed, much more research is needed before we accept that PPIs are truly causal. Surgery for GERD in patients over 65 is as effective as in the young and should be considered in appropriate candidates. Eosinophilic esophagitis, while not common in the elderly, frequently results in clinically important dysphagia. PPIs, topical oral steroids, and dietary interventions are all used individually and together to improve symptoms. PPIs remain first line and are required twice daily for at least 8 weeks as an initial trial. Dilation with either balloons or polyvinyl dilators are highly effective in patients with rings and focal strictures, can be performed safely, and limit the number of medications an elderly patient needs to take.

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Effect of aging on esophageal motility in patients with and without GERD

Cited by 13 publications

References 25 publications

Nutritional and lifestyle management of the aging journey: A narrative review

Nutritional and lifestyle management of the aging journey: A narrative review

Age-Related Differences in Clinical Characteristics and Esophageal Motility in Patients with Dysphagia

Managing Esophageal Dysphagia in the Elderly

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