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[Age-related clinical features in ischemic colitis]
T Kurumada1, M Machida, R Deguchi
1Department of Gastroenterology II, Tokai University School of Medicine.
Insights
Ischemic colitis affects both young and old patients. While vascular issues are key in older adults, constipation, particularly spastic constipation, is a significant factor in younger individuals.
Area of Science:
- Gastroenterology
- Vascular Medicine
Background:
- Ischemic colitis traditionally affects the elderly, often linked to vascular disorders like hypertension.
- Recent reports indicate an increasing incidence in younger populations, challenging the age-specific prevalence.
- Understanding age-related differences is crucial for accurate diagnosis and treatment.
Purpose of the Study:
- To investigate and compare the clinical features of ischemic colitis in aged and young patient groups.
- To identify age-specific etiological factors contributing to ischemic colitis.
Main Methods:
- A retrospective study of 30 ischemic colitis patients admitted over 5 years.
- Patients were categorized into two groups: aged (≥65 years) and young (≤65 years).
- Clinical data, serological results, endoscopic findings, lesion sites, and underlying causes were analyzed.
Main Results:
- No significant differences were observed in symptoms, serology, endoscopic findings, or treatment duration between age groups.
- Lesion extension was more prevalent in the aged group.
- Vascular factors were prominent in the aged group, whereas peristaltic factors, specifically constipation, were key in the young group.
- Spastic constipation was more common in the young, associated with no prior history of underlying disease or laparotomy.
- Paralytic constipation was more frequent in the aged, often linked to underlying diseases and laparotomy history.
Conclusions:
- Ischemic colitis is not exclusive to the elderly; young individuals are increasingly affected.
- Etiological factors differ by age, with vascular issues in the aged and constipation, particularly spastic constipation, in the young.
- Spastic constipation is presumed to be a significant etiological factor for ischemic colitis in younger patients.
Abstract:
Ischemic colitis has been considered to have relatively high prevalence in the elderly population with underlying vascular disorder such as hypertension. However, this disease has been recently reported increased in the young population so that it is not necessarily limited to the aged. The aim of the present study was to elucidate the characteristics of age-related clinical features in ischemic colitis. The subjects consisted of 30 patients with ischemic colitis admitted to our hospital during the last 5 years. They were divided into the aged group more than 65 years old and the young group aged 65 or less. As a result, there were no significant differences in symptoms, resulted serological examination, endoscopic findings, and treatment period. Lesion sites were more extended in the aged group. Concerning underlying disease and etiologic factors, the vascular factor was important in the aged group, while the peristaltic factor, especially constipation was important in the young group. Ten of the 30 patients had habitual constipation, and the aged group had a high percentage of paralytic constipation, while the young group had a high rate of spastic constipation. Many patients with paralytic constipation had a history of underlying diseases and laparotomy, while the patients with spastic constipation did not have such a history. Therefore, it is presumed that the spastic type of constipation is an etiologic factor in ischemic colitis.