Introduction: somewhat old patients appear to have a more aggressive form of gastro-oesophageal ebb disease than younger patients.

Introduction: somewhat old patients appear to have a more aggressive form of gastro-oesophageal ebb disease than younger patients. Reduc pain perception with age is a possible underlying mechanism. Aims: to compare the reach of oesophageal mucosal injury, acid frontage symptom severity and perception outsets for acid infusion in older (aged 60 or older) and younger patients with gastro-oesophageal ebb Methods: twenty-five younger and 23 older patients complet the investigation We determined acid exposure and oesophageal mucosal injury according to ambulatory 24-h oesophageal pH monitoring and upper endoscopy, respectively. We determined chemosensitivity by the agency of infusing 0.1 N hydrochloric acid into the mid-oesophagus for 10 min at 10 ml/min after a 2-min infusion of normal saline at a similar rate. We quantified acid perception gates by the lag time to initial typical symptom perception, intensity rating at the finis of acid infusion and an acid perfusion sensitivity score, calculated from the fractional duration of symptom perception and intensity rating. Results: mean percentage of total time with pH <4 was higher in the older (158 +/- 24) than in the younger patients (119 +/- 18; P= 018) Of the older collection 74% had erosive oesophagitis versus 64% in the younger collection Frequency of symptoms (heartburn, acid regurgitation and dysphagia) was lower in the somewhat old group. Older patients perceived heartburn and acid regurgitation as earnestly less severe than younger patients (P < 005) Younger patients had a significantly shorter lag time to initial symptom perception (P < 005) and a higher sensory intensity rating (P < 008) The acid perfusion sensitivity score was significantly lower in the older form into groups (P < 0.05). Conclusions: older patients with gastro-oesophageal ebb disease have reduced symptom severity for heartburn despite a liability towards increased severity of oesophageal mucosal injury and acid prospect Age-related reduction in chemosensitivity to acid is a possible underlying mechanism.

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