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[Crohn's disease in the elderly].

Guido Basile1, Stefania Chiarenza, Pietro Di Mari

  • 1Università degli Studi di Catania, Dipartimento di Chirurgia, Sezione di Chirurgia d'Urgenza e Generale. gbasile@unict.it

Annali Italiani Di Chirurgia
|December 2, 2006
PubMed
Summary

Crohn's disease in the elderly presents with predominant ulcerative and fibrotic aspects, often with delayed diagnosis due to subtle symptoms. Treatment should be primarily medical, with surgery reserved for specific complications.

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Area of Science:

  • Gastroenterology
  • Geriatric Medicine

Context:

  • Crohn's disease (CD) affects approximately 10-15% of patients in older age groups.
  • Elderly patients with CD may present with atypical or subtle symptoms, leading to diagnostic delays.

Purpose:

  • To characterize Crohn's disease in the elderly population.
  • To compare the clinical presentation, pathology, and treatment outcomes of CD in elderly versus younger adults.

Summary:

  • A study observed 46 Crohn's disease patients over 10 years, with 4 (8.6%) being elderly.
  • Elderly patients showed a higher prevalence of fibrotic and ulcerative pathology, with colic location being more frequent.
  • Occlusive and hemorrhagic complications were more common in the elderly, necessitating a predominantly medical treatment approach, with surgery reserved for complications.

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Impact:

  • Highlights the importance of suspecting Crohn's disease in the elderly, even with non-specific symptoms, to ensure timely diagnosis and appropriate management.
  • Suggests that medical management should be the cornerstone of treatment for elderly Crohn's patients, with surgical interventions being conservative and reserved for specific indications.
  • Emphasizes increased risks of post-operative morbidity and mortality in the elderly due to comorbidities, reinforcing the preference for non-surgical interventions when feasible.