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Systematic review with meta-analysis: inflammatory bowel disease in the elderly
1Gastroenterology Unit, Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBEREHD), Hospital Universitario de La Princesa and Instituto de Investigación Sanitaria Princesa (IP), Madrid, Spain.
Alimentary Pharmacology & Therapeutics
|January 11, 2014
Summary
Caring for elderly patients with inflammatory bowel disease (IBD) requires modified treatment approaches. Older adults with IBD need careful consideration of therapies due to potential risks and altered responses.
Area of Science:
- Gastroenterology
- Geriatric Medicine
Background:
- Elderly patients constitute a growing segment of the inflammatory bowel disease (IBD) population.
- IBD diagnosis in individuals over 60 years old accounts for 10-15% of new cases and 10-30% of the overall IBD patient demographic.
Purpose of the Study:
- To conduct a critical review of existing data concerning the management of elderly IBD patients.
- To highlight differences in IBD care for older adults compared to younger populations.
Main Methods:
- Bibliographic searches were performed using MEDLINE up to June 2013.
- Review of available literature on the characteristics and treatment of IBD in the elderly.
Main Results:
- IBD in the elderly can be misdiagnosed as diverticular disease or ischemic colitis.
- Crohn's disease in older patients often presents with colonic involvement and a less complicated course.
- Treatment strategies for elderly IBD patients should adopt a 'start low, go slow' approach, with cautious use of thiopurines and anti-TNF agents due to potential for lower response rates and increased adverse events.
Conclusions:
- Standard IBD management protocols may need adjustments for elderly patients.
- Age-specific modifications are essential for effectively managing inflammatory bowel disease in older individuals.
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