REDUCED CHEMORECEPTOR SENSITIVITY IN PATIENTS WITH BARRETTS-ESOPHAGUSMAY BE RELATED TO AGE AND NOT TO THE PRESENCE OF BARRETTS EPITHELIUM

Background: Patients with Barrett's esophagus have demonstrated reduce d chemo-and mechanoreceptor sensitivity to acid infusion and balloon d istension, respectively, However, Barrett's esophagus is mainly a dise ase of the elderly, making age the possible underlying mechanism for a ltered pain perception in this patient population Objectives: To deter mine perception thresholds to acid infusion in elderly (> 65 yr) versu s younger (less than or equal to 50 yr) patients with Barrett's esopha gus, Methods: Twelve elderly and 10 younger patients, matched by lengt h of Barrett's mucosa, were recruited into the study, All patients par ticipated in our Barrett's esophagus surveillance program, The patient s were treated with omeprazole 20 to 60 mg/day and were symptom free, Chemosensitivity was determined by a modified acid perfusion test, in which acid perception thresholds were quantified by the lag time to in itial typical symptom perception, sensory intensity rating, and an aci d perfusion sensory score, Results: Five of the elderly patients with Barrett's esophagus had a negative test, whereas all younger patients: with Barrett's esophagus experienced typical symptom perception durin g acid infusion, Elderly patients with Barrett's esophagus had signifi cantly longer lag time to initial perception, lower acid perfusion sen sory score, and sensory intensity rating in comparison with the younge r patients, Conclusions: Reduced chemoreceptor sensitivity to acid per fusion that has previously been demonstrated in patients with Barrett' s esophagus may be related to age and not to the presence of Barrett's epithelium.