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Management of the Elderly Inflammatory Bowel Disease Patient.

  • Hruz P Department of Gastroenterology and Hepatology, Clarunis Basel, Basel, Switzerland, petr.hruz@clarunis.ch.
  • Juillerat P Department of Gastroenterology and Hepatology, University Clinic for Visceral Surgery and Medicine, University Hospital of Bern, Bern, Switzerland.
  • Kullak-Ublick GA Department of Clinical Pharmacology and Toxicology, University Hospital Zurich, University of Zurich, Zurich, Switzerland.
  • Schoepfer AM Department of Gastroenterology and Hepatology, Centre Hospitalier Universitaire Vaudois and University of Lausanne, Lausanne, Switzerland.
  • Mantzaris GJ Department of Gastroenterology, "Evangelismos-Ophthalmiatreion Athinon-Polycliniki" Hospitals, Athens, Greece.
  • Rogler G Department of Gastroenterology and Hepatology, University Hospital Zurich, University of Zurich, Zurich, Switzerland.
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  • 2020-01-15
Published in:
  • Digestion. - 2020
Crohn’s disease
Elderly
Management
Ulcerative colitis
English Inflammatory bowel disease (IBD) is increasingly diagnosed among elderly persons (older than 60 years). Epidemiological studies show that late-onset IBD is characterized by predominance of colonic disease, milder disease course, and less frequent occurrence of extraintestinal manifestations. However, due to comorbidities, polypharmacy and reduced resistance to severe disease course elderly patients have an increased risk of mortality. Drug treatment generally follows the same algorithms as in the younger IBD patients. This is challenging for the treating physician as this population is usually underrepresented in clinical trials and treatment outcomes as well as safety data on the elderly population are scarce. Choice of drugs should consider risk of infections, skin cancer, lymphoma, and metabolic as well as cardiovascular side effects. Considering comorbidities, surgical interventions such as colectomy with ileo-anal pouch anastomosis for refractory ulcerative colitis can be performed safely provided that the anal sphincter function is adequately maintained. Special attention should be given in this age group to general health issues, including nutrition, vaccination, bone, muscle, and mental health as well as colorectal and skin cancer screening.
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  • English
Open access status
bronze
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https://sonar.ch/global/documents/46850
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