[The elderly patient with esophageal and gastric disease]

The increasing percentage of elderly patients in gastroenterology requires special management of this patient group. In gastroesophageal reflux disease symptoms are not different in the older patients, but advanced disease and Barrett's syndrome are more frequently present. Medical treatment is the same as in the young population, and surgical anti-reflux procedures may be applied with identical success rates. The incidence of oral medication-induced esophageal injury in the elderly is high, but is often overlooked. Operative resection procedures in esophageal cancer are carried out in experienced centers without increase in mortality or perioperative complications. A high prevalence of H.p. infection in the elderly is, unfortunately, not followed by more frequent testing for H.p. in these patients or even by eradication treatment. NSAID induced lesions are present more frequently in older age, treatment is however by the same principles as in the young. Also, prevention of NSAID lesions is not performed differently in the elderly.

Elderly patients have similar symptoms in esophageal and gastric disease as younger patients do, but disease states are often more serious. These patients are treated by the same principles and should not be denied chances of curative operative procedures when indication is given. Surgery should however preferably be carried out in specialized centers.