Gastroesophageal reflux disease (GERD) is the most common upper gastrointestinal disorder seen in the elderly. The worldwide incidence of GERD is increasing as the incidence of Helicobacter pylori is decreasing. Altho...Gastroesophageal reflux disease (GERD) is the most common upper gastrointestinal disorder seen in the elderly. The worldwide incidence of GERD is increasing as the incidence of Helicobacter pylori is decreasing. Although elderly patients with GERD have fewer symptoms, their disease is more often severe. They have more esophageal and extraesophageal complications that may be potentially life threatening. Esophageal complications include erosive esophagitis, esophageal stricture, Barrett's esophagus and adenocarcinoma of the esophagus. Extraesophageal complications include atypical chest pain that can simulate angina pectoris; ear, nose, and throat manifestations such as globus sensation, laryngitis, and dental problems; pulmonary problems such as chronic cough, asthma, and pulmonary aspiration. A more aggressive approach may be warranted in the elderly patient, because of the higher incidence of severe complications. Although the evaluation and management of GERD are generally the same in elderly patients as for all adults, there are specific issues of causation, evaluation and treatment that must be considered when dealing with the elderly.展开更多
Lower gastrointestinal bleeding(LGIB) is an important worldwide cause of morbidity and mortality in the elderly.The incidence of LGIB increases with age and corresponds to the increased incidence of specific gastroint...Lower gastrointestinal bleeding(LGIB) is an important worldwide cause of morbidity and mortality in the elderly.The incidence of LGIB increases with age and corresponds to the increased incidence of specific gastrointestinal diseases that have worldwide regional variation,co-morbid diseases and polypharmacy.The evaluation and treatment of patients is adjusted to the rate and severity of hemorrhage and the clinical status of the patient and may be complicated by the presence of visual,auditory and cognitive impairment due to age and co-morbid disease.Bleeding may be chronic and mild or severe and life threatening,requiring endoscopic,radiologic or surgical intervention.Colonoscopy provides the best method for evaluation and treatment of patients with LGIB.There will be a successful outcome of LGIB in the majority of elderly patients with appropriate evaluation and management.展开更多
文摘Gastroesophageal reflux disease (GERD) is the most common upper gastrointestinal disorder seen in the elderly. The worldwide incidence of GERD is increasing as the incidence of Helicobacter pylori is decreasing. Although elderly patients with GERD have fewer symptoms, their disease is more often severe. They have more esophageal and extraesophageal complications that may be potentially life threatening. Esophageal complications include erosive esophagitis, esophageal stricture, Barrett's esophagus and adenocarcinoma of the esophagus. Extraesophageal complications include atypical chest pain that can simulate angina pectoris; ear, nose, and throat manifestations such as globus sensation, laryngitis, and dental problems; pulmonary problems such as chronic cough, asthma, and pulmonary aspiration. A more aggressive approach may be warranted in the elderly patient, because of the higher incidence of severe complications. Although the evaluation and management of GERD are generally the same in elderly patients as for all adults, there are specific issues of causation, evaluation and treatment that must be considered when dealing with the elderly.
文摘Lower gastrointestinal bleeding(LGIB) is an important worldwide cause of morbidity and mortality in the elderly.The incidence of LGIB increases with age and corresponds to the increased incidence of specific gastrointestinal diseases that have worldwide regional variation,co-morbid diseases and polypharmacy.The evaluation and treatment of patients is adjusted to the rate and severity of hemorrhage and the clinical status of the patient and may be complicated by the presence of visual,auditory and cognitive impairment due to age and co-morbid disease.Bleeding may be chronic and mild or severe and life threatening,requiring endoscopic,radiologic or surgical intervention.Colonoscopy provides the best method for evaluation and treatment of patients with LGIB.There will be a successful outcome of LGIB in the majority of elderly patients with appropriate evaluation and management.
