Does GERD increase with age?

As reported in MedWire (12/31, Albert) reported that after reviewing 16 studies, UK researchers concluded "that the prevalence of gastroesophageal reflux disease (GERD) does not increase with age, but that esophageal symptoms of sufferers become more severe as they get older." According to the paper in Alimentary Pharmacology and Therapeutics, the "largest of these studies (n=11,945) showed that the prevalence of severe reflux esophagitis increased significantly with age from 12% in those younger than 21 years to 37% in those aged 70 years or above," but "heartburn was less common in older than younger GERD patients." Investigators also pointed out that "esophageal 24-hour acid exposure time increased by 1.1% for each additional decade in age," while "ineffective esophageal motility increased and abdominal lower esophageal sphincter length decreased with age."

John Dent (University of Adelaide, Australia) and Anja Becher (Oxford PharmaGenesis Ltd, UK) carried out a systematic review of 16 studies, nine population-based and seven clinical, looking at the age-related prevalence and incidence of GERD and associated esophageal complications.

Overall, seven population-based studies (n=12,284) provided information on the age-related prevalence of GERD. The pooled results of these studies do not support an effect of age on GERD prevalence.

Two additional population-based studies evaluated the age-related incidence of GERD, showing only a marginally significant increase with increasing age.

Four clinical studies (n=13,074) assessed links between reflux esophagitis severity and age.

It was the largest of these studies (n=11,945) that showed the prevalence of severe reflux esophagitis increased significantly with age from 12% in those younger than 21 years to 37% in those aged 70 years or above. In contrast, heartburn was less common in older than younger GERD patients. The other three clinical studies showed similar results.

Finally, three additional clinical studies (n=1801) looked at the effects of age on gastroesophageal junction mechanics in GERD patients.

The largest of these studies (n=985), showed that esophageal 24-hour acid exposure time increased by 1.1% for each additional decade in age. It also demonstrated that ineffective esophageal motility increased and abdominal lower esophageal sphincter length decreased with age. Again, the other two studies produced similar results.