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Management of Ulcerative Colitis in the Elderly

  • Therapy in Practice
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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.

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Authors and Affiliations

  1. Department of Medicine, University of Arizona College of Medicine, Tucson, AZ, USA

    Manish P. Shrestha

  2. Division of Gastroenterology, University of Arizona College of Medicine, 1501 N Campbell Ave, PO Box: 24502B, Tucson, AZ, 85724, USA

    Sasha Taleban

  3. Department of Medicine, Arizona Center of Aging, Tucson, AZ, USA

    Sasha Taleban

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Correspondence to Sasha Taleban.

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

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Shrestha, M.P., Taleban, S. Management of Ulcerative Colitis in the Elderly. Drugs Aging 36, 13–27 (2019). https://doi.org/10.1007/s40266-018-0611-x

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