Canadian Health&Care; Mall

Peptic ulcer disease: Gastric ulcer disease is considered principally a disease of advanced age because it is found more commonly in elderly than in young patients. Gastric ulcers in older patients tend to be large and occur with greater propensity higher in the stomach. The majority of non-NSAID-associated gastric ulcers in such patients are found high on the lesser curve; therefore, special attention should be paid to examination of the fundus during endoscopy. Many previous studies have suggested specific factors that may be very important in the development of gastric ulcers in elderly patients, including the use of ASA and other NSAIDs, the rising prevalence of gastritis due to H pylori infection with advanced age and the high prevalence of smoking. Giant gastric ulcers, defined as ulcers larger than 2.5 cm in diameter, also occur more frequently in elderly patients. The peak incidence occurs from 60 to 70 years of age in men and from 70 to 80 years of age in women. These ulcers usually are benign but often mimic the clinical features of gastric cancer. About one-half of giant gastric ulcers present clinically as an acute or chronic bleed. In one study, the mortality rate from bleeding of giant gastric ulcers was as high as 37%, suggesting that early surgical intervention may be warranted. On the other hand, the perforation rate in these patients has been quoted to be as low as 5%. Gastroesophageal reflux: Gastroesophageal reflux is more common than peptic ulcer disease in both elderly and younger patients. The increased incidence of gastroesophageal reflux disease (GERD) in older patients may be due to the decrease in amplitude of esophageal peristalsis and delayed acid clearance from the esophagus, the increased incidence of sliding type hiatus hernia and the reduction in salivary bicarbonate response to esophageal acid exposure. Many medications may also decrease the lower esophageal sphincter pressure and thus make elderly patients more prone to GERD. When heartburn and acid regurgitation are predominant symptoms, they can be regarded as highly specific indicators of reflux, but when they are present together with other dyspeptic symptoms, reflux cannot be diagnosed reliably. Retrosternal pain occurs much less commonly in elderly than in young patients. Vomiting and anorexia are encountered more often in elderly patients with reflux than in young patients with reflux, and are more frequently described than heartburn. GERD is more difficult to diagnose in elderly patients because of increased pain tolerance and the increased gastric pH that may accompany atrophic gastritis. Symptoms may be attributed to other underlying diseases such as coronary artery disease. Because symptoms are frequently so atypical, more intensive investigation in elderly individuals is often required to obtain a specific diagnosis. If you made a decision to treat your problem fast and efficiently, you will be pleased to find a wide selection of required medications available at the Canadian Health&Care Mall. The prices are very low and you can get your drugs by mail within a very short period.