By Dr. Roy Patankar
Along with joint, bone, and back pain, Gastroesophageal reflux disease (GERD) is a common occurrence in older people. A large number of senior citizens encounter this condition. It will be imperative for each and every one to pay attention to their health.
Gastroesophageal reflux disease (GERD) is a digestive disorder that tends to impact the ring of muscle between the esophagus and stomach. One may suffer from it due to being overweight or obese, pregnancy, delayed emptying of the stomach (gastroparesis), rheumatoid arthritis, scleroderma, or lupus, smoking, foods like chocolate, fatty or fried foods, coffee, and alcohol, large meals, eating before bed, and certain medications. The symptoms are chest pain, heartburn, nausea, vomiting, difficulty in breathing, swallowing problems, and a lump in the throat. Medicines like painkillers and asthma medicines tend to worsen Gerd.
GERD in senior citizens
- GERD is commonly seen in elder patients. But elderly patients tend to have a higher tolerance for GERD symptoms compared to younger patients, and thus are less likely to report these symptoms. Moreover, elderly patients are likely to report GERD symptoms such as chest pain, dysphagia, respiratory symptoms (hoarseness, cough, wheezing), nausea, and vomiting, especially patients having erosive esophagitis. It is essential to look for both typical and atypical symptoms.
- Elderly patients tend to have lower esophageal motility and peristalsis, which prevents adequate clearance of acid. But this can be worsened by certain comorbidities such as diabetes mellitus and cerebrovascular disease. Certain medications can weaken lower esophageal sphincter (LES) tone and also predispose them to GERD.
- Elderly patients without alarm symptoms of unintentional weight loss, gastrointestinal bleeding, dysphagia, odynophagia, anemia, and persistent vomiting can be given PPI. For managing GERD, counseling regarding lifestyle modifications can help to avoid GERD triggers. Other helpful tips such as elevation of the head of the bed, not eating within 3 hours of sleeping, and weight loss (when indicated). Main treatment is the use of acid suppressing medicines like ppi. These do have some side effects in the longer term and she not be used long term. Lap or more recently robotic Fundoplication is a minimally invasive surgery that cures gerd with very short hospital stay and minimal problems. This should be done in patients who need long term drugs or are poorly controlled with drugs
How people with GERD can take care of themselves: Eat food in smaller proportions, do not sleep immediately after your meal, elevate your head while sleeping, quit smoking, and avoid chocolate, caffeine, and processed foods. Being overweight can worsen the symptoms so maintain an optimum weight.
(The author is a Gastroenterologist and Director of Zen Multispecialty Hospital, Chembur, Mumbai. Views expressed are personal and do not reflect the official position or policy of the FinancialExpress.com.)