{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,9,12]],"date-time":"2025-09-12T18:13:15Z","timestamp":1757700795684},"reference-count":29,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2007,4,18]],"date-time":"2007-04-18T00:00:00Z","timestamp":1176854400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J of Gastro and Hepatol"],"published-print":{"date-parts":[[2007,5]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p><jats:bold>Background:\u2002<\/jats:bold> Gastroesophageal reflux disease (GERD) impairs the patient's quality of life (QOL), but the effect of long\u2010term maintenance therapy in elderly patients is unknown.<\/jats:p><jats:p><jats:bold>Methods:\u2002<\/jats:bold> We conducted a long\u2010term prospective study. Forty\u2010four GERD patients (11 males; mean age 74\u2003years; QUEST score of at least 6 points) were enrolled in this study. Step\u2010down therapy was selected (proton\u2010pump inhibitor [PPI], histamine\u20102 receptor antagonist and prokinetic agents for 1\u2003month, respectively). Optimal medication for each patient was continued for 5\u2003years. The efficacy, safety of treatment and reflux symptoms were analyzed. The profiles of the patients who had to continue PPI maintenance therapy were also analyzed.<\/jats:p><jats:p><jats:bold>Results:\u2002<\/jats:bold> Reflux symptoms were reduced by the PPI based step\u2010down therapy (baseline 13.8\u2003times\/month, after 3.2\u2003times\/month, <jats:italic>P<\/jats:italic>\u2003&lt;\u20030.001). Reflux symptoms improved in 34 patients (77%). None of the 44 patients had to cease treatment because of side\u2010effects and none experienced any complications during the 5\u2010year period. The prevalence of <jats:italic>Helicobacter pylori<\/jats:italic> (<jats:italic>Hp<\/jats:italic>) infection in the PPI group (29%, 4\/14) was significantly lower (<jats:italic>P<\/jats:italic>\u2003&lt;\u20030.01) than in the other treatment group (72%, 21\/29). The serum pepsinogen I\/II ratio in the PPI treatment group (5.7\u2003\u00b1\u20030.5) was significantly higher (<jats:italic>P<\/jats:italic>\u2003&lt;\u20030.01) than in the others (4.0\u2003\u00b1\u20030.3). The predictive factors for PPI maintenance therapy were <jats:italic>Hp<\/jats:italic>\u2010negative status and serum pepsinogen I\/II ratio &gt;6.0 (odds ratio 12.0, 95% confidence interval 2.7\u201354.2).<\/jats:p><jats:p><jats:bold>Conclusions:\u2002<\/jats:bold> Long\u2010term medication for GERD selected on the basis of the patient's profile (i.e. <jats:italic>Hp<\/jats:italic> status and gastric atrophy) improved reflux symptoms.<\/jats:p>","DOI":"10.1111\/j.1440-1746.2007.04871.x","type":"journal-article","created":{"date-parts":[[2010,8,16]],"date-time":"2010-08-16T12:27:37Z","timestamp":1281961657000},"page":"639-644","update-policy":"http:\/\/dx.doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":13,"title":["Long\u2010term gastroesophageal reflux disease therapy improves reflux symptoms in elderly patients: Five\u2010year prospective study in community medicine"],"prefix":"10.1111","volume":"22","author":[{"given":"Masaki","family":"Miyamoto","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ken","family":"Haruma","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Masao","family":"Kuwabara","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Makoto","family":"Nagano","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Takeshi","family":"Okamoto","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mio","family":"Tanaka","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2007,4,18]]},"reference":[{"key":"e_1_2_6_2_2","doi-asserted-by":"publisher","DOI":"10.3109\/00365529309098350"},{"key":"e_1_2_6_3_2","doi-asserted-by":"publisher","DOI":"10.1023\/B:DDAS.0000007857.15694.15"},{"key":"e_1_2_6_4_2","doi-asserted-by":"publisher","DOI":"10.1007\/s005350050293"},{"key":"e_1_2_6_5_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0002-9270(01)02580-1"},{"key":"e_1_2_6_6_2","doi-asserted-by":"publisher","DOI":"10.1080\/003655298750026697"},{"key":"e_1_2_6_7_2","doi-asserted-by":"publisher","DOI":"10.1053\/gast.1996.v111.pm8698230"},{"key":"e_1_2_6_8_2","doi-asserted-by":"publisher","DOI":"10.1023\/A:1008841022998"},{"key":"e_1_2_6_9_2","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.322.7282.344"},{"key":"e_1_2_6_10_2","doi-asserted-by":"publisher","DOI":"10.1053\/j.gastro.2003.12.001"},{"key":"e_1_2_6_11_2","doi-asserted-by":"publisher","DOI":"10.1097\/00042737-200203000-00012"},{"key":"e_1_2_6_12_2","first-page":"37","article-title":"Natural course of gastroesophageal reflux disease: 17\u201322\u2010year follow\u2010up of 60 patients","volume":"92","author":"Isolauri J","year":"1997","journal-title":"Am. 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