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Management of Ulcerative Colitis in the Elderly

  • Manish P. Shrestha
  • Sasha Taleban
Therapy in Practice

Abstract

The incidence rate of ulcerative colitis (UC) in older patients is rising. Diagnosis of UC may be difficult in older patients as several common gastrointestinal disorders can mimic UC in these patients. Compared with younger adults, left-sided colitis is more common in older-onset UC, while rectal bleeding, abdominal pain, and extraintestinal manifestations are less common. The disease course of older-onset UC may be similar to that of adult-onset UC. The management of UC in older patients includes medical and surgical options. A majority of older UC patients are treated with 5-aminosalicylates. The underuse of immunosuppressants or biologics may lead to poor disease control, higher use of corticosteroids, and worse clinical outcomes in older UC patients. Serious infections and malignancy are the most concerning complications of immune-modifying agents or biologics in the elderly. Timely surgical referral of older UC patients with poor disease control is of utmost importance as elective colectomy may be associated with improved survival in these patients.

Notes

Compliance with ethical standards

Conflicts of interest

M.P. Shrestha declares no conflicts of interest. S. Taleban has served on the Advisory Board for Janssen.

Funding

No sources of funding were used to support the writing of this review.

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© Springer Nature Switzerland AG 2018

Authors and Affiliations

  1. 1.Department of MedicineUniversity of Arizona College of MedicineTucsonUSA
  2. 2.Division of GastroenterologyUniversity of Arizona College of MedicineTucsonUSA
  3. 3.Department of MedicineArizona Center of AgingTucsonUSA

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