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Old-age inflammatory bowel disease onset: a different problem?
World J Gastroenterol. 2011 Jun 14; 17(22):2734-9.WJ

Abstract

Inflammatory bowel disease (IBD) in patients aged > 60 accounts for 10%-15% of cases of the disease. Diganostic methods are the same as for other age groups. Care has to be taken to distinguish an IBD colitis from other forms of colitis that can mimick clinically, endoscopically and even histologically the IBD entity. The clinical pattern in ulcerative colitis (UC) is proctitis and left-sided UC, while granulomatous colitis with an inflammatory pattern is more common in Crohn's disease (CD). The treatment options are those used in younger patients, but a series of considerations related to potential pharmacological interactions and side effects of the drugs must be taken into account. The safety profile of conventional immunomodulators and biological therapy is acceptable but more data are required on the safety of use of these drugs in the elderly population. Biological therapy has risen question on the possibility of increased side effects, however this needs to be confirmed. Adherence to performing all the test prior to biologic treatment administration is very important. The overall response to treatment is similar in the different patient age groups but elderly patients have fewer recurrences. The number of hospitalizations in patients > 65 years is greater than in younger group, accounting for 25% of all admissions for IBD. Mortality is similar in UC and slightly higher in CD, but significantly increased in hospitalized patients. Failure of medical treatment continues to be the most common indication for surgery in patients aged > 60 years. Age is not considered a contraindication for performing restorative proctocolectomy with an ileal pouch-anal anastomosis. However, incontinence evaluation should be taken into account an individualized options should be considered.

Authors+Show Affiliations

Gastroeneterology Service, Hospital de Manises, Valencia 46940, Spain. jhinojosad@gmail.com

Pub Type(s)

Journal Article

Language

eng

PubMed ID

21734781

Citation

del Val, Joaquin Hinojosa. "Old-age Inflammatory Bowel Disease Onset: a Different Problem?" World Journal of Gastroenterology, vol. 17, no. 22, 2011, pp. 2734-9.
del Val JH. Old-age inflammatory bowel disease onset: a different problem? World J Gastroenterol. 2011;17(22):2734-9.
del Val, J. H. (2011). Old-age inflammatory bowel disease onset: a different problem? World Journal of Gastroenterology, 17(22), 2734-9. https://doi.org/10.3748/wjg.v17.i22.2734
del Val JH. Old-age Inflammatory Bowel Disease Onset: a Different Problem. World J Gastroenterol. 2011 Jun 14;17(22):2734-9. PubMed PMID: 21734781.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Old-age inflammatory bowel disease onset: a different problem? A1 - del Val,Joaquin Hinojosa, PY - 2010/08/12/received PY - 2011/05/04/revised PY - 2011/05/11/accepted PY - 2011/7/8/entrez PY - 2011/7/8/pubmed PY - 2011/9/17/medline KW - Crohn’s disease KW - Eldery population KW - Inflammatory bowel diseases KW - Ulcerative colitis SP - 2734 EP - 9 JF - World journal of gastroenterology JO - World J Gastroenterol VL - 17 IS - 22 N2 - Inflammatory bowel disease (IBD) in patients aged > 60 accounts for 10%-15% of cases of the disease. Diganostic methods are the same as for other age groups. Care has to be taken to distinguish an IBD colitis from other forms of colitis that can mimick clinically, endoscopically and even histologically the IBD entity. The clinical pattern in ulcerative colitis (UC) is proctitis and left-sided UC, while granulomatous colitis with an inflammatory pattern is more common in Crohn's disease (CD). The treatment options are those used in younger patients, but a series of considerations related to potential pharmacological interactions and side effects of the drugs must be taken into account. The safety profile of conventional immunomodulators and biological therapy is acceptable but more data are required on the safety of use of these drugs in the elderly population. Biological therapy has risen question on the possibility of increased side effects, however this needs to be confirmed. Adherence to performing all the test prior to biologic treatment administration is very important. The overall response to treatment is similar in the different patient age groups but elderly patients have fewer recurrences. The number of hospitalizations in patients > 65 years is greater than in younger group, accounting for 25% of all admissions for IBD. Mortality is similar in UC and slightly higher in CD, but significantly increased in hospitalized patients. Failure of medical treatment continues to be the most common indication for surgery in patients aged > 60 years. Age is not considered a contraindication for performing restorative proctocolectomy with an ileal pouch-anal anastomosis. However, incontinence evaluation should be taken into account an individualized options should be considered. SN - 2219-2840 UR - https://www.unboundmedicine.com/medline/citation/21734781/full_citation L2 - https://www.wjgnet.com/1007-9327/full/v17/i22/2734.htm DB - PRIME DP - Unbound Medicine ER -