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GERD in the Elderly

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Updated August 29, 2012

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While GERD affects millions of people, the odds of developing this disorder increases with age. Thus, the elderly are more likely than younger adults to suffer from GERD.

An elderly patient may not connect their symptoms with heartburn or GERD because their symptoms may be different from what is considered the normal symptoms of the disease. Usually when we think of the symptoms of GERD we think heartburn foremost. That burning sensation that can start behind the breastbone. In the elderly, symptoms often show up in the mouth, throat, or lungs.

Symptoms that can occur in the throat include hoarseness, dry cough, feeling like there is a lump in the throat or food stuck in the throat, trouble swallowing (dysphagia), chronic sore throat. Respiratory symptoms that can occur include coughing and wheezing.

Elderly patients with some chronic conditions are at a higher risk of developing GERD. They may take medications that cause the LES to relax, which can lead to acid reflux. Elderly patient also tend to have decreased saliva production. Saliva can help with acid reflux because saliva is alkaline, so it can help neutralize the acid. Saliva can also relieve heartburn by bathing the esophagus and lessening the effects of acid refluxed into the esophagus by washing it back down to the stomach.

If you have been diagnosed with GERD, you may have already talked to your doctor about how to best treat your symptoms. If you haven't had that discussion with him or her, it is important that you do so in order to ensure proper treatment.

Though you may not be able to eliminate heartburn completely, you can take some steps to minimize your discomfort.

  • Don't eat foods that are known heartburn triggers. These include chocolate, citrus fruits and juices, tomatoes and tomato-based products, mustard, vinegar, mint products, and spicy, highly seasoned, fried, and fatty foods. For a complete list of foods to avoid, check out this chart. For foods that have a low risk of causing heartburn, check out this chart.

  • Avoid drinks containing caffeine (coffee, tea, cola) because these can relax the LES.

  • Avoid alcohol. Alcohol relaxes the LES. Read the article on alcohol and heartburn for more information.

  • Don't eat big meals. Eat several small meals throughout the day instead.

  • Wait at least three hours after your last meal before going to bed.

  • Sleep with your head and shoulders propped up with a wedge pillow or elevate the head of your bed six to eight inches. This will allow gravity to work for you and it will help keep your stomach acids where they should be--in your stomach and not in your esophagus. For some tips on easing nighttime heartburn, read this article.

  • Wear clothes that are loose and comfortable. You need to avoid any tightness around your waist and stomach.

  • Sit upright in a comfortable chair rather than slouching.

  • Don't smoke. Read about smoking and heartburn to find out the reasons smoking increases heartburn.

  • You should always check with your doctor before taking any over-the-counter remedies, but there are a few choices you have that can help eliminate heartburn. Some heartburn relievers such as Tums, Maalox, Mylanta, Rolaids, or Gaviscon may prove helpful. Again, it's important that you check with your doctor before taking any of these remedies.

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Sources:

Anil Minocha, M.D., Christine Adamec. How to Stop Heartburn: Simple Ways to Heal Heartburn and Acid Reflux. New York, NY: John Wiley & Sons, Inc., 2001

Carol Ann Rinzler, Ken DeVault, MD. Heartburn & Reflux for Dummies. Hoboken, NJ: Wiley Publishing, Inc., 2004.

"Heartburn, Hiatal Hernia, and Gastroesophageal Reflux Disease (GERD)." NIH Publication No. 03­0882 June 2003. NIH Publication No. 03­0882 May 2007. National Digestive Diseases Information Clearinghouse (NDDIC). 17 Aug 2012

Carlo Calabrese, Anna Fabbri, Giulio Di Febo, . "Long-term management of GERD in the elderly with pantoprazole." March 2007 U.S. National Library of Medicine. Web. 17 Aug 2012.

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