Inflammatory Bowel Disease in the Elderly

Alexander I. Aspinall, MD, PhD and Jon B. Meddings, MD, FRCPC, Division of Gastroenterology, Faculty of Medicine, University of Calgary, Calgary, AB.

The inflammatory bowel diseases (IBD)--Crohn's disease (CD) and ulcerative colitis (UC)--have a second peak of onset after the age of 60. Discerning IBD from alternate diagnoses is a great challenge in the geriatric population, as other diseases commonly encountered in the elderly can mimic IBD. The possibilities include ischemic colitis, diverticulitis and infectious colitis. Diagnosing and treating IBD should involve consultation with a gastroenterologist, but the approaches do not vary significantly from the strategies used in younger patients. Therapeutic modalities used in younger age groups are also applicable to the geriatric population, but great attention needs to be given to side effects and drug interactions.
Key words: inflammatory bowel, crohn's disease, ulcerative colitis, differential diagnosis

Epidemiology and Pathophysiology
The inflammatory bowel diseases--Crohn's disease (CD) and ulcerative colitis (UC)--are illnesses of unknown cause.