Clinical characteristics and natural history of colitis in the elderly

The clinical behavior and course of ischemic, ulcerative, and Crohn's colitis in the elderly are analyzed. Fifty-two patients with ischemic colitis, 11 with ulcerative colitis, and four with Crohn's colitis composed the study group. Patients with ischemic colitis were older and had a higher incidence of arteriosclerotic cardiovascular disease than those with inflammatory bowel disease. A potentially obstructing colonic lesion was present in 12% of those with ischemic colitis. Spontaneous rapid resolution occurred in 42% of those with ischemic colitis, but in no patient with ulcerative or Crohn's colitis. Of the 31 remaining patients with ischemic colitis, 20% had recurrent disease and 80% required operation. Almost 10% of patients with ischemic colitis died postoperatively. Of those patients with ulcerative colitis, two developed toxic dilitation, three required operation, and three died on the first admission. All patients with Crohn's colitis required operation. The prognosis for colitis in elderly patients, regardless of type, is worse than in young patients.