title: [Clinical analysis of endoscopy negative gastroesophageal reflux disease in the elderly].
abstract: The purpose of this study was to describe the clinical analysis of endoscopy negative gastroesophageal reflux disease (EN-GERD) in the elderly. 35 elderly patients of both sexes, 60 years or older with EN-GERD, 33 elderly patients with reflux esophagitis and 41 elderly patients as control group were included in this study. All patients witnessed verbal informed consent to participate in the study. EN-GERD was defined as the patients with normal endoscopy despite of heartburn as their chief complaint and who were completely relieved with heartburn after one-week omeprazole treatment. Helicobacter pylori infection between EN-GERD, reflux esophagitis and control were 37.1%, 24.2% and 56.1%, respectively. The gastric mucosal atrophy under endoscopic findings and the serum pepsinogen I, II ratio in EN-GERD had no significant differences with control. A hiatus hernia with EN-GERD was diagnosed 37.1%, which was lower significantly than 87.9% with reflux esophagitis. The motility of the stomach using the acetaminophen method was the same in patients with EN-GERD, reflux esophagitis and control. The anxiety score of the Hospital Anxiety and Depression Scale was significantly higher in the patients with EN-GERD than in those with reflux esophagitis and control. On the other hand, the severity of reflux symptoms in the patients with EN-GERD was similar as those with reflux esophagitis. We concluded that general anxiety plays an important role in the severity of the reflux symptoms in the patients with EN-GERD. As such symptoms in EN-GERD significantly impair the quality of life, further studies of patients with EN-GERD are greatly needed.
authors.affiliation: Second Department of Internal Medicine, Faculty of Medicine, Kagoshima University.
authors.forename: Takafumi
authors.initials: T
authors.lastname: Yamamoto
authors.forename: Jun
authors.initials: J
authors.lastname: Matsumoto
authors.forename: Terukatsu
authors.initials: T
authors.lastname: Arima
mesh_terms: D000368:Aged; D016145:Endoscopy, Digestive System; D005260:Female; D005744:Gastric Acid / Q000378:metabolism; D005764:Gastroesophageal Reflux / Q000175:diagnosis / Q000503:physiopathology* / Q000523:psychology; D016481:Helicobacter Infections / Q000150:complications; D016480:Helicobacter pylori; D006551:Hernia, Hiatal / Q000150:complications; D006801:Humans; D008297:Male; D008347:Manifest Anxiety Scale; D008875:Middle Aged; D012720:Severity of Illness Index