Management of the Elderly Inflammatory Bowel Disease Patient.

Hruz, Petr; Juillerat, Pascal; Kullak-Ublick, Gerd-Achim; Schoepfer, Alain M.; Mantzaris, Gerassimos J.; Rogler, Gerhard (2020). Management of the Elderly Inflammatory Bowel Disease Patient. Digestion, 101(S1), pp. 105-119. Karger 10.1159/000503099

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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.

Item Type:

Journal Article (Review Article)

Division/Institute:

04 Faculty of Medicine > Department of Gastro-intestinal, Liver and Lung Disorders (DMLL) > Clinic of Visceral Surgery and Medicine > Gastroenterology

UniBE Contributor:

Juillerat, Pascal

Subjects:

600 Technology > 610 Medicine & health

ISSN:

0012-2823

Publisher:

Karger

Language:

English

Submitter:

Rahel Fuhrer

Date Deposited:

22 Dec 2020 11:43

Last Modified:

22 Dec 2020 11:43

Publisher DOI:

10.1159/000503099

PubMed ID:

31935714

Uncontrolled Keywords:

Crohn’s disease Elderly Management Ulcerative colitis

BORIS DOI:

10.7892/boris.149246

URI:

https://boris.unibe.ch/id/eprint/149246

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