Abstract
Although inflammatory bowel disease is often considered an affliction of the young, significant proportions of those presenting with either Crohn’s disease or Ulcerative Colitis are elderly An understanding of the differences in disease presentation in the elderly compared to that in the young is important in making a timely diagnosis. In addition, operative approaches, when indicated, must be tailored to the needs of the aging patient.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
Preview
Unable to display preview. Download preview PDF.
References
Grimm IS, Friedman LS. Inflammatory bowel disease in the elderly. Gastroenterol Clin North Am 1990;19:361–389.
Crohn BB, Ginzburg L, Oppenheimer GD. Regional ileitis: a pathologic and clinical entity. JAMA 1932;99:1323–1329.
Sandler RS, Golden AL. Epidemiology of Crohn’s disease. J Clin Gastroenterol 1986;8:160–165.
Myren J, Bouchier IAD, Watkinson G, et al. The OMGE multinational inflammatory bowel disease survey 1976–1986: a further report on 3175 cases. Scand J Gastroenterol 1988;144(suppl):11–19.
Fleischer DE, Grimm IS, Friedman LS. Inflammatory bowel disease in older patients. Med Clin North Am 1994;78: 1303–1319.
Van Patter WN, Bargen JA, Dokerty MB, et al. Regional enteritis. Gastroenterology 1954;26:347.
Lapidus A, Bernell O, Hellers G, et al. Incidence of Crohn’s disease in Stockholm County 1955–1989. Gut 1997;41: 480–486.
Nordenvall B, Brostrom O, Berglund M, et al. Incidence of ulcerative colitis in Stockholm County 1955–1979. Scand J Gastroenterol 1985;20:783.
Morris T, Rhodes J. Incidence of ulcerative colitis in the Cardiff region 1968–1977. Gut 1984;25:846.
Binder V, Both H, Hansen PK, et al. Incidence and prevalence of ulcerative colitis and Crohn’s disease in the county of Copenhagen, 1962–1978. Gastroenterology 1982; 83:563.
Bjornsson S, Thorgeirsson T. Ulcerative colitis in Iceland: an epidemiologic study. Nord Med 1983;98:298–301.
Berner J, Kjaer T. Ulcerative colitis and Crohn’s disease on the Faroe Islands 1964–1983. Scand J Gastroenterol 1986; 21:188–192.
Sinclair TS, Brunt PW, Mowat NAG. Nonspecific proctocolitis in northeastern Scotland: a community study. Gastroenterology 1983;85:1.
Devlin HB, Datta D, Dellipiani AW. The incidence and prevalence of inflammatory bowel disease in North Tees health district. World J Surg 1980;4:183–193.
Shivananda S, Pena AS, Nap M, et al. Epidemiology of Crohn’s disease in Regio Leiden, The Netherlands. Gastroenterology 1987;93:966.
Softley A, Myren J, Clamp SE, et al. Inflammatory bowel disease in the elderly patient. Scand J Gastroenterol 1988;23(suppl 144):27–30.
Langholz E, Munkholm P, Haagen Nielsen O, et al. Incidence and prevalence of ulcerative colitis in Copenhagen County from 1962 to 1967. Scand J Gastroenterol 1991; 26:1247.
Evans JG, Acheson DE. An epidemiological study of ulcerative colitis and regional enteritis in the Oxford area. Gut 1965;6:311.
Garland CF, Lilienfeld AM, Mendeloff AI, et al. Incidence rates of ulcerative colitis and Crohn’s disease in fifteen areas of the United States. Gastroenterology 1981;81:1115.
Sedlack RE, Nobrega FT, Kurland LT, et al. Inflammatory colon disease in Rochester, Minnesota 1935–1964. Gastroenterology 1972;62:935.
Rose JDR, Roberts GM, Williams G, et al. Cardiff Crohn’s disease jubilee: the incidence over 50 years. Gut 1988;29:346.
Kyle J. Prognosis after ileal resection for Crohn’s disease. Br J Surg 1971;58:735.
Lee FT, Costello T. Crohn’s disease in Blackpool: incidence and prevalence 1968–1980. Gut 1985;26:274.
Lockhart-Mummery HE. Crohn’s disease of the large bowel. Br J Surg 1972;59:823.
Walker MA, Pennington CR, Pringle R. Crohn’s disease in the elderly. Br Med J Clin Res Educ 1985;291:1725–1726.
Shapiro PA, Peppercorn MA, Antonioli DA, et al. Crohn’s disease in the elderly. Am J Gastroenterol 1981;76:132–137.
Brandt L, Boley S, Goldberg L, et al. Colitis in the elderly: a reappraisal. Am J Gastroenterol 1981;76:239–245.
Eisen GM, Schutz SM, Washington MK, et al. Atypical presentation of inflammatory bowel disease in the elderly. Am J Gastroenterol 1993;88:2098–2101.
Stalnikowicz R, Eliakim R, Diab R. Crohn’s disease in the elderly. J Clin Gastroenterol 1989;11:411–415.
Harper PC, McAuliffe TL, Beeken WL. Crohn’s disease in the elderly: a statistical comparison with younger patients matched for sex and duration of disease. Arch Intern Med 1986;146:753–755.
Gupta S, Saverymuttu SH, Keshavarzian A, et al. Is the pattern of inflammatory bowel disease different in the elderly? Age Ageing 1985;14:366–370.
Fabricius PJ, Gyde SN, Shouler P, et al. Crohn’s disease in the elderly. Gut 1985;26:461–465.
Elliott PR, Ritchie JK, Lennard-Jones JE. Prognosis of colonic Crohn’s disease. Br Med J 1985;291:178.
Serpell JW, Johnson CD. Complicated Crohn’s disease in the over 70 age group. Aust NZ J Surg 1991;61:427–431.
Jones HW, Hoare AM. Does ulcerative colitis behave differently in the elderly? Age Ageing 1988;17:410–414.
Brandt LJ, Boley SJ, Mitsudo S. Clinical characteristics and natural history of colitis in the elderly. Am J Gastroenterol 1982;77:382–386.
Eisenberg RL, Montgomery CK, Margulis AR. Colitis in the elderly: ischemic colitis mimicking ulcerative and granulomatous colitis. Am J Radiol 1979;133:1113–1118.
Van Rosendaal G, Andersen MA. Segmental colitis complicating diverticular disease. Can J Gastroenterol 1996;10: 361–364.
Editorial. Crohn’s disease in the elderly: a diagnostic problem. Br Med J 1973;873:188–189.
Peppercorn MA. Drug-responsive chronic segmental colitis associated with diverticula: a clinical syndrome in the elderly. Am J Gastroenterol 1992;87:609–612.
Tchirkow G, Lavery IC, Fazio VW. Crohn’s disease in the elderly. Dis Colon Rectum 1983;26:177–181.
Heppell J, Kelly KA, Dozois RR. Surgery for ulcerative colitis. In: Nicholls RJ, Dozois RR (eds) Surgery of the Colon and Rectum. New York: Churchill Livingstone, 1997: 593–615.
Strong SA. Crohn’s disease. In: Nicholls RJ, Dozois RR (eds) Surgery of the Colon and Rectum. New York: Churchill Livingstone, 1997:617–644.
Mekhijan HS, Sweitz DM, Watts HD, et al. National cooperative Crohn’s disease study: factors determining recurrence of Crohn’s disease after surgery. Gastroenterology 1979;77:907–913.
Farmer RG, Hawk WA, Turnbull RB Jr. Indications for surgery in Crohn’s disease: analysis of 500 cases. Gastroenterology 1976;71:245–250.
O’Brien JJ, Bayless TM, Bayless JA. Use of azathioprine or 6-mercaptopurine in the treatment of Crohn’s disease. Gastroenterology 1991;101:39–46.
Michelassi F, Testa G, Pomidor WJ, et al. Adenocarcinoma complicating Crohn’s disease. Dis Colon Rectum 1993;36: 654–661.
Fazio VW. Toxic megacolon in ulcerative colitis and Crohn’s colitis. Gastroenterology 1980;9:389–407.
Abscal J, Diaz-Rojas F, Jorge J, et al. Free perforation of the small bowel in Crohn’s disease. World J Surg 1982;6: 216–220.
Homan WP, Tang CK, Thorbjarnason B. Acute massive hemorrhage from intestinal Crohn’s disease. Arch Surg 1976;111:901–905.
Lashner BA, Evans AA, Hanauer SB. Preoperative total parenteral nutrition for bowel resection in Crohn’s disease. Dig Dis Sci 1989;34:741–746.
Papaioannau N, Piris J, Lee ECG, Kettlewell MGW. The relationship between histological inflammation in the cut ends after resection of Crohn’s disease and recurrence. Gut 1979;20:A916.
Kotanagi H, Kramer K, Fazio VW, Petras RE. Do microscopic abnormalities at resection margins correlate with increased anastomotic recurrence in Crohn’s disease? Retrospective analysis of 100 cases. Dis Colon Rectum 1991;34: 909–916.
Hamilton SR, Reese J, Pennington L, et al. The role of resection margin frozen section in the surgical management of Crohn’s disease. Surg Gynecol Obstet 1985;160:57–62.
Fazio VW, Marchetti F, Church JM, et al. Effect of resection margins on the recurrence of Crohn’s disease in the small bowel: a randomized controlled trial. Ann Surg 1996;224: 563–573.
McLeod RS, Wolff BG, Steinhart AH, et al. Prophylactic mesalamine treatment decreases postoperative recurrence of Crohn’s disease. Gastroenterology 1995;109:404–413.
Young-Fadok TM, Nelson H, Fleshman J, et al. Laparoscopic resection of Crohn’s disease. Poster presentation at Digestive Disease Week, New Orleans, May 1998.
Young-Fadok TM, Sgambati SA, Nelson H. Benefits of laparoscopic resection for Crohn’s disease: a case-matched series. Presentation at Society of American Gastrointestinal and Endoscopic Surgeons, San Antonio, TX, March 1999.
Stocchi L, Nelson H, Young-Fadok TM, et al. Safety and advantages of laparoscopic versus open colectomy in the elderly: a matched-control study. Presentation at the American Society of Colon and Rectal Surgeons, Washington, DC, May 1999.
Nugent FW, Roy MA. Duodenal Crohn’s disease: an analysis of 89 cases. Am J Gastroenterol 1989;84:249–254.
Goligher JC. The long-term results of excisional surgery for primary and recurrent Crohn’s disease of the large bowel. Dis Colon Rectum 1985;28:51–55.
Prabhakar LP, Laramee C, Nelson H, et al. Avoiding a stoma: role for segmental or abdominal colectomy in Crohn’s colitis. Dis Colon Rectum 1997;40:71–78.
Sher ME, Bauer JJ, Gorfine S, et al. Low Hartmann’s procedure for severe anorectal Crohn’s disease. Dis Colon Rectum 1992;35:975–980.
Keighley MRB, Buchmann P, Lee JR. Assessment of anorectal function in selection of patients for ileo-rectal anastomosis in Crohn’s colitis. Gut 1982;23:102–107.
Sagar PM, Dozois RR, Wolff BG. Long-term results of ileal pouch-anal anastomosis in patients with Crohn’s disease. Dis Colon Rectum 1996;39:893–898.
Wolff BG. Crohn’s disease: the role of surgical treatment. Mayo Clin Proc 1986;61:292–295.
Buchmann P, Keighley MRB, Allan RN, et al. Natural history of perianal Crohn’s disease: ten year follow-up: a plea for conservation. Am J Surg 1980;140:642–644.
Jeffrey PJ, Ritchie JK, Parks AG. Treatment of haemorrhoids in patients with inflammatory bowel disease. Lancet 1977;1:1084–1085.
Fry RD, Shemesh EI, Kodner IJ, Timmcke A. Techniques and results in the management of anal and perianal Crohn’s disease. Surg Gynecol Obstet 1989;168:42–48.
Levien DH, Surrell J, Mazier W. Surgical treatment of anorectal fistulas in Crohn’s disease. Surg Gynecol Obstet 1989;169:133–136.
Fuhrman GM, Larach SW. Experience with perirectal fistulas in patients with Crohn’s disease. Dis Colon Rectum 1989;32:847–848.
Sohn N, Korelitz BI, Weinstein MA. Anorectal Crohn’s disease: definitive surgery for fistulas and recurrent abscesses. Am J Surg 1980;139:394–397.
Makowiec F, Jehle EC, Becker HD, Starlinger M. Clinical course after transanal advancement flap repair of perianal fistula in patients with Crohn’s disease. Br J Surg 1995;82: 603–606.
Crim RW, Fazio VW, Lavery IC. Rectal advancement flap repair in Crohn’s patients—factors predictive of failure. Dis Colon Rectum 1990;33:P3.
Ekbom A, Helmick C, Zack M, et al. Ulcerative colitis and colorectal cancer: a population-based study. N Engl J Med 1990;323:1228–1233.
Hendriksen C, Kreiner S, Binder V. Long term prognosis in ulcerative colitis—based on results from a regional patient group from the county of Copenhagen. Gut 1985;26:158–163.
Devroede G. Risk of cancer in inflammatory bowel disease. In: Winawer SJ, Schottenfeld R, Sherlock R (eds) Colorectal Cancer: Prevention, Epidemiology, and Screening. Philadelphia: Lippincott-Raven, 1980.
Reiser JR, Waye JD, Janowitz HD, Harpaz N. Adenocarcinoma in strictures of ulcerative colitis without antecedent dysplasia by colonoscopy. Am J Gastroenterol 1994;89:119–122.
Blackstone MO, Riddle RH, Rogers BH, Levin B. Dysplasia-associated lesion or mass (DALM) detected by colonoscopy in long-standing ulcerative colitis: an indication for colectomy. Gastroenterology 1981;80:366–374.
Lennard-Jones JE. Colitic cancer: supervision, surveillance, or surgery? Gastroenterology 1995;109:1388–1391.
Provenzale D, Kowdley KV, Arora S, Wong JB. Prophylactic colectomy or surveillance for chronic ulcerative colitis? A decision analysis. Gastroenterology 1995;109:1188–1196.
Greenstein AJ, Janowitz HD, Sachar DB. The extraintestinal complications of Crohn’s disease and ulcerative colitis: a study of 700 patients. Medicine 1976;55:401.
Hawley PR. Emergency surgery for ulcerative colitis. World J Surg 1988;12:169–173.
Hurst RD, Finco C, Rubin M, Michelassi F. Prospective analysis of perioperative morbidity in one hundred consecutive colectomies for ulcerative colitis. Surgery 1995;118: 748–755.
Lewis WG, Sagar PM, Holdsworth PJ, et al. Restorative proctocolectomy with end to end pouch-anal anastomosis in patients over the age of fifty. Gut 1993;34:948–952.
McHugh SM, Diamant NE. Effect of age, gender, and parity on anal canal pressures: contribution of impaired anal sphincter function to fecal incontinence. Dig Dis Sci 1987;32: 726–736.
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2001 Springer Science+Business Media New York
About this chapter
Cite this chapter
Young-Fadok, T.M., Wolff, B.G. (2001). Inflammatory Bowel Disease in the Elderly. In: Rosenthal, R.A., Zenilman, M.E., Katlic, M.R. (eds) Principles and Practice of Geriatric Surgery. Springer, New York, NY. https://doi.org/10.1007/978-1-4757-3432-4_43
Download citation
DOI: https://doi.org/10.1007/978-1-4757-3432-4_43
Publisher Name: Springer, New York, NY
Print ISBN: 978-1-4757-3434-8
Online ISBN: 978-1-4757-3432-4
eBook Packages: Springer Book Archive