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Current Treatment Options in Gastroenterology
Published in: Current Treatment Options in Gastroenterology 3/2015

01-09-2015 | Geriatrics (S Katz, Section Editor)

Challenges in the Diagnosis and Management of Inflammatory Bowel Disease in the Elderly

Author: Sasha Taleban, MD

Published in: Current Treatment Options in Gastroenterology | Issue 3/2015

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Opinion statement

Among inflammatory bowel disease (IBD) patients, 4–12 % is diagnosed after the age of 60. Both the rates of elderly and IBD are increasing worldwide. In older patients, the diagnosis of Crohn’s disease (CD) and ulcerative colitis (UC) is made more difficult due to polypharmacy and multimorbidity along with disease processes that mimic IBD. The clinical presentation in older-onset IBD differs from younger patients, and there is minimal disease progression over time. The management of the older IBD patient involves a combination of medical and surgical strategies. Few treatment efficacy studies exist in elderly IBD as most authors have focused on the adverse events related to therapy. A vast number of incident CD and UC cases in elderly have been treated with 5-aminosalicylic acid agents and do not require the use of immune modifying agents or biologics. Many other older IBD patients are prescribed long-term corticosteroids despite guidelines recommending more effective and safer maintenance therapy regimens. Serious infections, malignancy, and drug interactions are the most concerning complications of medical therapy. There are particularly important health care maintenance issues in older IBD patients including vaccinations, colorectal cancer screening, and bone loss prevention.
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Metadata
Title
Challenges in the Diagnosis and Management of Inflammatory Bowel Disease in the Elderly
Author
Sasha Taleban, MD
Publication date
01-09-2015
Publisher
Springer US
Published in
Current Treatment Options in Gastroenterology / Issue 3/2015
Print ISSN: 1092-8472
Electronic ISSN: 1534-309X
DOI
https://doi.org/10.1007/s11938-015-0059-6

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