The Prevalence of Reflux Esophagitis in the Elderly and Its Associated Risk Factors
Abstract: Reflux esophagitis
is a common problem in the elderly. Compare to the Western Countries,
esophageal cancer where reflux esophagitis is the most predominant risk factor
is considered rare in Asia. Many other risk factors have not been well studied
especially in most Asian countries. The objective of this study is to evaluate
the presence of reflux esophagitis in elderly patients and its associated risk
factors.
Method: This was a cross-sectional study in elderly patients who
underwent upper gastrointestinal endoscopy. Patients who received long-term
proton pump inhibitor (PPI) therapy, suffered from gastrointestinal
malignancies, recently receiving chemotherapy agents, diagnosed with
cerebrovascular disease or Helicobacter pylori infection were excluded.
Statistical analyses were performed using the SPSS software version 17.00 (SPSS
Inc., Chicago, Illinois, USA).
Results: A total of 238 elderly patients were enrolled. Patients’ mean
age was 69.8 ± 6.8 years old. Reflux esophagitis was found in 22 (9.2%)
patients. Several comorbidities were found in these patients, such as diabetes,
hypertension, coronary artery disease, chronic kidney disease, and liver
cirrhosis. The only factor that associated with reflux esophagitis was the
presence of hiatus hernia esophagus (p = 0.038). However, reflux esophagitis
seemed to be more found in the elderly patients who have history of reflux
inducing drugs consumption without any proton pump inhibitor (PPI) protection.
Conclusion: Reflux esophagitis is still a major problem in the elderly.
The presence of hiatus hernia might give an important consideration of upper
gastrointestinal endoscopy screening. However, it would be a debate matter with
regards to the cost burden and the low risk of esophageal cancer in Asian
countries.
Keywords: reflux
esophagitis; elderly; hiatus hernia; proton pump inhibitor
Author: Cosmas Rinaldi A
Lesmana, Billy Angga, Levina S Pakasi, Waldemar Simanjuntak, Laurentius A
Lesmana
Journal Code: jpkedokterangg160412
