Gastric function assessed by Gastropanel in very old patients (over 80 years old) and appropriateness of PPIs administration

BACKGROUND Chronic atrophic gastritis (CAG) is a stomach precancerous condition often related with Helicobacter pylori (Hp) infection. This feature is characterized by hypo- achloridria due to loss of appropriate gastric glands. Gastropanel ® is a non-invasive test able to detect both CAG and Hp infection. This test is defined as a “serological biopsy” pointing out both morphological and functional status of gastric mucosa. Therefore, PPIs administration is not recommended in such patients. In literature no data are available on CAG and the use of PPIs in very old patients. AIM The aim of the present study is to investigate morpho-functional status of gastric mucosa by non-invasive test and the use of PPIs in very old patients. MATERIALS AND METHODS Eigthy-nine patients (M:F=1:3) over 80 years old (mean age: 86,98 years old; range: 80-103) consecutively admitted to Internal Medicine and Critical Subacute Care Unit were enrolled in this study. Gastropanel ® was performed in every patients (Biohit ®, Helsinki, Finland). RESULTS CAG was diagnosed by serology in 42 out of 89 patients (47.2%) namely 17 patients had chronic atrophic body gastritis (Pepsinogen I <25 µg/L, Gastrin 17>10 pmol/L), 20 patients had chronic atrophic antral gastritis (Gastrin 17<2 pmol/L under PPIs administration) and 5 patients had atrophic pangastritis (Pepsinogen I <25 µg/L and Gastrin 17<2 pmol/L ). Hp infection was present in 44 patients (49.4%): 31 patients had high antibodies anti-Hp levels, in 13 patients with CAG a previous Hp infection was presumed. 76 patients had PPI therapy of whom 22 showed a picture of body CAG (N=17) or chronic atrophic pangastritis (N=5). CONCLUSIONS According with epidemiological trends, a picture of CAG was find in 47.2% out of very old patients. In particular, 25.5% of them experienced hypo-achloridria, therefore PPI administration in such patients seems completely inappropriate. Gastropanel ® seems to be useful as non-invasive test in critical subjects over 80 y.o in order to assess both gastric morphological and functional disorders.