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Open Access 01-12-2020 | Ulcerative Colitis | Research article

Elderly-onset vs adult-onset ulcerative colitis: a different natural history?

Authors: Irene Zammarchi, Francesco Lanzarotto, Rosanna Cannatelli, Francesca Munari, Federica Benini, Alessandro Pozzi, Alberto Lanzini, Chiara Ricci

Published in: BMC Gastroenterology | Issue 1/2020

Abstract

Background

Incidence of ulcerative colitis (UC) in elderly population is increasing because of ageing and because of its minimal impact on life span. Data on natural history, outcomes and therapeutic strategies are limited.

Our aim is to characterize UC in elderly-onset patients followed at our Inflammatory Bowel Disease outpatient clinic and compare with adult-onset UC.

Methods

From January 2000 to June 2019, 94 patients with UC diagnosed after the age of 65 years (elderly group, E-O) were identified and matched 1–1 according to gender and calendar year of diagnosis with patients diagnosed with UC at age between 40 and 64 years (adult age, A-O).

Results

Comorbidity Index (3.8 vs 1.6, p < 0.0005) was higher for elderly UC patients. Symptoms at presentation were similar between the two groups, although abdominal pain was more common in adults, and weight loss was more common in the elderly. At diagnosis, left colitis (61% vs 39%) and proctitis (14% vs 26%) (p = 0.011) were more frequent in the elderly. Therapy and clinical behaviour were similar. Surgery was more frequently performed in the elderly (20% vs 9%, p = 0.02), while biological therapy was less used (2.1% vs 22%, p < 0.0005). Complications were more frequent in the elderly. Extraintestinal manifestations were lower in elderly patients (9.6% vs 19.2%, p = 0.061). Time to first relapse was similar between the two groups. Mortality (p < 0.0005) was higher in elderly patients.

Conclusions

Ulcerative Colitis has similar presentation and behaviour in elderly and adults patients. However, the elderly are more fragile because of comorbidities, increased risk of infections and disease-related complications.

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Title: Elderly-onset vs adult-onset ulcerative colitis: a different natural history?
Authors: Irene Zammarchi
Francesco Lanzarotto
Rosanna Cannatelli
Francesca Munari
Federica Benini
Alessandro Pozzi
Alberto Lanzini
Chiara Ricci
Publication date: 01-12-2020
Publisher: BioMed Central
Keywords: Ulcerative Colitis
Chronic Inflammatory Bowel Disease
Published in: BMC Gastroenterology / Issue 1/2020
Electronic ISSN: 1471-230X
DOI: https://doi.org/10.1186/s12876-020-01296-x

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Elderly-onset vs adult-onset ulcerative colitis: a different natural history?

Abstract

Background

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Results

Conclusions

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