Presbyesophagus: a reappraisal

The gastrointestinal tract undergoes change with aging, and the esophagus is not exempt from those changes. Failure of peristalsis in the older esophagus was labeled "presbyesophagus" over 35 years ago. Modern manometric techniques and classification systems have challenged this concept, yet there are clearly age-related changes in the esophagus. The lower esophageal sphincter changes little. Esophageal peristalsis (body) is more likely to fail in older patients, but some of this failure may be caused by damage from gastroesophageal reflux disease. The pharynx and upper esophageal sphincter also undergo age-related changes in health and disease. The ability to sense events in the esophagus fails with aging, which may cause patients with severe mucosal disease to present with less severe symptoms. Failure of the esophagus thus does not appear to be an inevitable consequence of aging, but the esophagues does undergo change with aging, and these changes should be considered in evaluation of older patients with esophageal complaints.