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2007, Number 5

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Rev Med Inst Mex Seguro Soc 2007; 45 (5)

Frequency of gastroesophageal reflux disease in elderly patients attending a family medicine clinic

Peralta-Pedrero ML, Lagunes-Espinosa AL, Cruz-Avelar A, Juárez-Cedillo T, Rodríguez-Moctezuma R, López-Carmona JM, Munguía-Miranda C

Language: Spanish
References: 22
Page: 447-452
PDF size: 130.63 Kb.


ABSTRACT

Objectives: To ascertain the prevalence of gastroesophageal reflux disease (GERD) in elderly people attending to family medicine clinics.
Material and methods: the study was conducted by using a prospective design in which participants were randomly selected from a family medicine clinic located in Mexico City. The study was run from August to September 2003, and included patients aged sixty years or older, regardless of gender. They should not have cognitive damage, which was ascertained by the Folstein Mini Mental State Examination. Those patients that did not accept to participate and those having incomplete or illegible medical records were excluded. The socio-demographic characteristics test and Carlsson-Dent test were applied. The information about diagnosis, drugs prescriptions, and pharmacological and no pharmacological gastroesophageal protection was obtained from the medical charts and prescriptions.
Results: 400 elderly patients were evaluated by using the Carlsson-Dent test. GERD prevalence was 25% (IC 95 % 21-29) the average age of patients with and without GERD was 68 ± 7 years and 70 ± 7 years respectively (p = .002). Women suffered GERD more frequently than men (p = 0.001). GERD diagnosis was not found in any of the reviewed medical charts. Antacids, histamine-2 receptor antagonists (H2 As) and were prescribed in 39% (IC 95 % 34-44) of patients with GERD and in 18% (IC 95 % 15-21) without GERD.
Conclusions: Elderly patients attending to primary care facilities often have GERD symptoms, but they are not properly diagnosed or followed up. The Carlsson-Dent questionnaire is an alternative to identify GERD patients.


REFERENCES

  1. Uscanga-Domínguez L, Nogueira-de-Rojas JR, Gallardo E, Bernal-Reyes R, González M, Ballesteros-Amozurrutia MA. Enfermedad por reflujo gastroesofágico. Resultados del consenso del Grupo Mexicano para el Estudio de la ERGE. Asociación Mexicana de Gastroenterología. Rev Gastroenterol Mex 2002;67:216-223.

  2. Organización de las Naciones Unidas. Informe de la Segunda Asamblea Mundial sobre Envejecimiento. Madrid, España: ONU; 2002.

  3. Instituto Nacional de Estadística Geografía e Informática. XII Censo General de Población y Vivienda 2000. México: INEGI.

  4. Achem AC, Achem SR, Stark ME, Devault K. Failure of esophageal peristalsis in older patients: association with esophageal acid exposure. Am J Gastroenterol 2003;98:35-39.

  5. Katz P. Progress in geriatrics. gastroesophageal reflux disease. J Am Geriatr Soc 1998;46:1558-1565.

  6. Greenwald DA. Aging, the gastrointestinal tract, and risk of acid-related disease. Am J Med 2004; 117:8-13.

  7. Pilotto A. Aging and upper gastrointestinal disorders. Best Pract Res Clin Gastroenterol 2004; 18:73-81.

  8. Tapia R, Cravioto P, Yáñez CD, De La Rosa B. Consumo de drogas médicas en población de 60 a 65 años en México. Encuesta Nacional de Adicciones 1993. Salud Publica Mex 1996;38:458-465.

  9. Arbas E, Garzón R, Suárez A. Consumo de medicamentos en mayores de 65 años: problemas potenciales y factores asociados. Aten Primaria 1998;22:165-170.

  10. Joshua J. The economic and quality-of-life impact of symptomatic gastroesophageal reflux disease. Am J Gastroenterol 2003;98:8-14.

  11. Richter JE. Gastroesophageal reflux disease in the older patient: presentation, treatment, and complications. Am J Gastroenterol 2000;95:368-373.

  12. Pilotto A, Franceschi M, Paris F. Recent advances in the treatment of GERD in the elderly: focus on proton pum inhibitors. Int J Clinic Pract 2005;59:1204-1209.

  13. Folstein MF, Folstein SE, McHugh PR. “Mini-Mental State”: a practical method for grading the cognitive state of patients for the clinician. J Psychiatr Res 1975;12:189-198.

  14. Carlsson R, Dent J, Bolling-Sternevald E, Johnsson F, Junghard O, Luritsen K, Riley S, Lundell L. The usefulness of a structured questionnaire in the assessment of symptomatic gastroesophageal reflux disease. Scand J Gastroenterol 1998;33:1023-1029.

  15. Reyes-Frausto S. Population ageing in the Mexican Institute of Social Security: health policy and economic implications. México: Fundación Mexicana para la Salud; 2001.

  16. Chait M. Complications of gastroesophageal reflux disease in the elderly. Ann Long-Term Care 2005:13;27-32 .

  17. Mascort J, Ferrándiz J, Marzo M. Guías de práctica clínica. Un paso hacia delante. Aten Primaria 2002;30:195-196.

  18. De Vault KR, Castell DO. Updated guidelines for diagnosis and treatment of gastroesophageal disease. Am J Gastroenterol 2005;100:190-200.

  19. Gómez-Escudero O, Remes-Troche JM, Ruiz JC, Peláez-Luna M, Schmulson MJ, Valdovinos-Díaz MA. Utilidad diagnóstica del cuestionario de Carlsson-Dent en la enfermedad por reflujo gastroesofágico. Rev Gastroenterol Mex 2004;69(1):16-23.

  20. Dent J, El-Serag HB, Wallander MA, Johansson S. Epidemiology of gastroesophageal reflux disease: a systematic review. Gut 2005;54:710-717.

  21. Dent J, Jones R, Kahrilas P, Talley NJ. Management of gastroesophageal reflux disease in general practice. BMJ 2001;322:344-347.

  22. Díaz-Rojas F, Morales-Lara JR, Sánchez-Vázquez C. Prescripción de naproxen en el adulto mayor. Rev Med IMSS 2002,40:409-414.




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