The prevalence of gastroesophageal reflux disease (GERD) tends to increase with age and elderly individuals have higher odds of developing severe disease.1 Ranitidine is an H2 antagonist which has been shown to be effective in the management of GERD.2

It is expected that surgical treatment for GERD in the elderly is going to increase. In a recent study, investigators evaluated the results of laparoscopic fundoplication (LF) for GERD-related diseases in the elderly patients.3

Among the 302 cases which underwent initial LF for GERD-related diseases between June 2008 and February 2019, investigators categorized them into elderly (65 years of age or older) and non-elderly (64 years of age or younger). On performing propensity score matching with respect to five factors, including gender, body mass index, esophageal hiatal hernia, extent of reflux esophagitis, and use of mesh, 57 cases each were identified.

With regard to preoperative disease status, pH < 4 holding time was found to be as 2.8% (0.5-10.7%) in the elderly group and 3.4% (0.6-8.0%) in the non-elderly group. There was no difference in terms of illness period (p = 0.889 and p = 0.263, respectively).

There was no difference with regard to the operative time (155 vs. 139 min, p = 0.092) and estimated blood loss (both ≒ 0 ml, p = 0.298); however, there was longer postoperative hospital stay in the elderly group [7 (7-9) vs. 7 (7-7), p = 0.007]. Esophageal hiatal hernia, reflux esophagitis, and acid reflux time in the esophagus were shown to improve after surgery in both the groups (p < 0.001 in both groups).

It was concluded that the treatment results of LF for GERD-related diseases in the elderly patients seem to be similar to those in the non-elderly.

References

1. Calabrese C, Fabbri A, Di Febo G. Long-term management of GERD in the elderly with pantoprazole. Clin Interv Aging. 2007 Mar; 2(1): 85–92.
2. Sherbaniuk R, Wensel R, Bailey R, et al. Ranitidine in the treatment of symptomatic gastroesophageal reflux disease. J Clin Gastroenterol. 1984;6(1):9-15.
3. Hoshino M, Omura N, Yano F, et al. Therapeutic effect of laparoscopic fundoplication for GERD-related disease in the elderly. Gen Thorac Cardiovasc Surg. 2022 Jan;70(1):72-78.