Esomeprazole plus trimebutine maleate improves symptoms, esophageal function, and acid control without increasing risks in elderly GERD: a real-world retrospective study.

OBJECTIVES

Elderly patients with gastroesophageal reflux disease (GERD) often exhibit inadequate response to proton pump inhibitor monotherapy due to accompanying motility disorders. This study evaluated the real-world safety and efficacy of esomeprazole (EMZ) combined with trimebutine maleate (TM) in this population.

METHODS

This retrospective analysis included elderly GERD patients treated at The People's Hospital of Yongcheng from July 2022 to June 2025, categorized into EMZ monotherapy and EMZ + TM combination groups. Symptom efficacy and GerdQ scores were assessed at baseline, 4 and 8 weeks. Esophageal motility, 24-hour pH monitoring, inflammatory markers, liver and kidney function, and adverse reactions were evaluated before and after 8 weeks.

RESULTS

A total of 184 patients were included (86 monotherapy, 98 combination). The combination group showed a higher total effective rate and lower GerdQ scores at 4 weeks and 8 weeks (all P<0.05). After 8 weeks, lower esophageal sphincter resting pressure, lower esophageal sphincter relaxation rate, and distal contractile integral were significantly higher, while ineffective contractions and total acid exposure time were significantly lower in the combination group (all P<0.05). Inflammatory markers were also significantly lower (all P<0.05). No significant differences in liver, kidney function, or adverse reactions were observed.

CONCLUSIONS

Adding TM to EMZ improves symptom control, esophageal motility, acid exposure, and inflammatory markers in elderly GERD patients without compromising safety.