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Esophagus

pp 1–5 | Cite as

Risk of hemorrhage and stricture significantly increases in elderly patients with proton pump inhibitor (PPI)-resistant reflux esophagitis

  • Nana Takenouchi
  • Shintaro Hoshino
  • Yoshimasa Hoshikawa
  • Tomohide Tanabe
  • Mai Koeda
  • Eri Momma
  • Yumiko Ishikawa
  • Noriyuki Kawami
  • Mitsuru Kaise
  • Katsuhiko IwakiriEmail author
Original Article
  • 29 Downloads

Abstract

Background

To examine the clinical characteristics, including complications, of patients older than 75 years of age with proton pump inhibitor-resistant reflux esophagitis.

Methods

Patients who were resistant to standard-dose proton pump inhibitors were enrolled in the present study. Eligible patients (n = 26) were divided into those who were older (n = 11) and younger (n = 15) than 75 years of age. Clinical characteristics including complications (hemorrhage and stricture), body mass index, the severity of reflux esophagitis, Helicobactor pylori infection, gastric mucosal atrophy, hiatal hernia, kyphosis, and the use of antithrombotic agents were examined. The efficacy of 20 mg vonoprazan for proton pump inhibitor-resistant reflux esophagitis was also investigated.

Results

The severity of reflux esophagitis was significantly higher in the elderly group than in the non-elderly group. No other significant differences were observed between the groups. The proportion of patients with hemorrhage was significantly larger in the elderly group than in the non-elderly group. Similarly, the proportion of patients with stricture was significantly larger in the elderly group than in the non-elderly group. Nine out of 10 patients in the elderly group and all patients in the non-elderly group achieved healing after the 4-week administration of 20 mg vonoprazan. No significant differences were observed in healing rates between the groups.

Conclusion

Among patients with proton pump inhibitor-resistant reflux esophagitis, the rates of severe reflux esophagitis and complications (hemorrhage and/or stricture) were significantly higher in elderly patients than in non-elderly patients. Regardless of age, 20 mg vonoprazan was effective for proton pump inhibitor-resistant reflux esophagitis.

Keywords

PPI-resistant reflux esophagitis Complication Stricture Bleeding Vonoprazan 

Notes

Acknowledgements

The authors thank Ms. Satoko Nishimura for her administrative assistance.

Compliance with ethical standards

Ethical Statement

All procedures followed were in accordance with the approval of the Ethics Committee of Nippon Medical School Hospital and the guidelines set forth in the Declaration of Helsinki revised in 2000. Informed consent was obtained from all subjects included in the study.

Conflict of interest

Katsuhiko Iwakiri has received lecture fees from Takeda Pharmaceutical Co., Ltd. and Otsuka Pharmaceutical Co., Ltd.. The remaining authors declare that they have no conflicts of interest.

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Copyright information

© The Japan Esophageal Society 2019

Authors and Affiliations

  • Nana Takenouchi
    • 1
  • Shintaro Hoshino
    • 1
  • Yoshimasa Hoshikawa
    • 1
  • Tomohide Tanabe
    • 1
  • Mai Koeda
    • 1
  • Eri Momma
    • 1
  • Yumiko Ishikawa
    • 1
  • Noriyuki Kawami
    • 1
  • Mitsuru Kaise
    • 1
  • Katsuhiko Iwakiri
    • 1
    Email author
  1. 1.Department of Gastroenterology, Nippon Medical SchoolGraduate School of MedicineBunkyo-kuJapan

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