Personalized approach for examination of an elderly patient with gastroesophageal reflux disease

O.A. Denisova, M.A. Livzan, A.P. Denisov, O.A. Kun

Omsk State Medical University

Nowadays, general approaches to the diagnosis of gastroesophageal reflux disease (GERD) have not yet been developed, taking into account the age characteristics specificity of patient’s category, despite the high prevalence of this disease in the elderly patients.

Aim: to optimize the patient management tactics for elderly patients with GERD based on a personalized approach development to diagnosis.

Patients and Methods: an open cohort prospective controlled study included 120 patients with GERD, divided into two groups, identical in numerical structure. Treatment group: subjects aged 60–86 years (mean age 68,2±2,7 years). Control group: subjects aged 25–59 years (46,68±2,4 years).

Results: the frequency of heartburn decreased in patients older than 60 years (60.2%), compared to young people (77.3%; p < 0.05), during concurrent increasing of retrosternal pai n (44.2% and 7.1%, respectively; p < 0.001), dysphagia (16.8% and 3.9%; p <0.05) and cough (56.1% and 12.5%; p < 0.001) incidences. The more severe GERD state in elderly patients was due to a complex of various risk factors (smoking, male sex, overweight and obesity, duodenogastric reflux, hiatal hernia, regular use of nitrates, angiotensin-converting enzyme inhibitors). A direct correlation was found between age and the total time index pH <4 (r_xy = 0.420, p <0.05), as well as the duration of the most prolonged reflux (r_xy = 0.433, p <0.05). When conducting an alginate test, a positive specimen was determined in 78.2% of cases in elderly patients, and in 75.2% of cases in young and mature patients, which confirms the possibility of using alginate test as an early screening method in patients with GERD.

Conclusion: based on the data obtained, the personalized approach to the examination of patients with GERD was developed and introduced, taking into account age, somatic status, as well as the possible predictors’ presence that aggravate the pathological process course.

Keywords: gastroesophageal reflux disease (GERD), elderly patients, personalized approach, diagnosis, clinical features, alginate test.

For citation: Denisova O.A., Livzan M.A., Denisov A.P., Kun O.A. Personalized approach for examination of an elderly patient with gastroesophageal reflux disease. RMJ. 2019;7:2–5.