From the Guidelines
Presbyesophagus is a condition characterized by age-related changes in the esophagus, including a decline in esophageal motility and function.
Key Characteristics
- It is often associated with dysphagia, which is a common feature of many neurological disorders, including those that affect the central swallowing network or downstream peripheral nerves, muscles, and structures 1.
- The term presbyphagia has been coined to describe the multifactorial changes of swallowing physiology associated with aging, which can lead to impaired oropharyngeal swallow, i.e., oropharyngeal dysphagia (OD) 1.
Clinical Presentation
- Presbyesophagus may present with symptoms such as dysphagia, regurgitation, and chest pain, although it is often asymptomatic.
- The condition is more common in older adults, with a prevalence of 16% in the 70-79 year old group and 33% in the 80-year old group 1.
Diagnosis and Treatment
- Diagnosis of presbyesophagus is typically made through esophageal manometry, which reveals a decrease in peristaltic amplitude and coordination.
- Treatment is generally supportive, with medications used to relax the esophageal smooth muscle and improve symptoms, although specific treatment options are not mentioned in the provided evidence 1.
From the Research
Definition of Presbyesophagus
- Presbyesophagus refers to the age-related changes in the esophagus, particularly the deterioration of esophageal motility with advancing age 2.
- It was first labeled as "presbyesophagus" over 35 years ago to describe the failure of peristalsis in the older esophagus 2.
Age-Related Changes in the Esophagus
- The esophagus undergoes changes with aging, including a decrease in esophageal peristalsis and an increase in the proportion of simultaneous contractions 3.
- The lower esophageal sphincter (LES) pressure and length, as well as the upper esophageal sphincter (UES) pressure and length, decrease with age 3.
- The amplitude and velocity of peristaltic waves also decrease with age, while the contractile duration increases 4.
Clinical Implications
- The age-related changes in the esophagus can lead to esophageal symptoms, such as dysphagia and reflux, in older adults 4, 2.
- The diagnosis of esophageal motility disorders should take into account the age-related changes in esophageal function, as normal esophageal motility deteriorates with advancing age 3.