Crohn’s disease in the elderly: Clinical presentation and manifestations from a tertiary referral center in Turkey

INTRODUCTION: There is no precise consensus at present on age to define elderly patients with inflammatory bowel disease (IBD), but recently, age of more than 60 years has been widely accepted. Characteristics of IBD in the elderly are somewhat different from what is seen in younger patients. The elderly have milder disease activity, and therapeutic options are fewer because of their age and features such as comorbidities, drug interactions, and loss of organ function. There are few reports on Crohn’s disease in the elderly. Herein, first report on this topic with respect to population of this country is presented.
METHODS: Characteristics of 95 patients with Crohn’s disease, who were over age 60 from 3125 patients with IBD treated in our clinic between 1996 and 2015 were analyzed. Research was performed using patient files, and outpatient clinic visits, when possible.
RESULTS: Median age of the group was 66 years, and male: female ratio was 1.6. Of the total, 48.4% of the patients had colonic disease, 37.9% had ileocolonic disease, and 13.7% had small bowel disease. Data indicated that 23.1% of patients had undergone surgical procedures, which were primarily right hemicolectomy and ileotransversostomy. Disease was most often managed with mesalazine or azathioprine. It was also determined that 12.6% patients had 2 or more comorbidities, and findings indicated coronary heart disease and hypertension were most prevalent.
DISCUSSION AND CONCLUSION: Analysis revealed similar features in characteristics of disease compared with recent knowledge reported in the literature. This is the first report from our country to describe Crohn’s disease in the elderly population, and the number of patients is sufficient to provide general information about this group.

Yaþlý Populasyonda Crohn Hastalýðý: Klinik Prezentasyon ve Seyir, Turkiyeden Referans Merkezi Verileri

GÝRÝÞ ve AMAÇ: Inflamatuar Barsak Hastalarýnda (IBH) yaþlý tanýmý icin net olarak kabul edilmiþ bir yaþ yoktur ancak son yayýnlarda 60 yaþ yaygýn kullaným bulmaktadýr. IBH yaþlý popülasyonda genç eriþkinden daha farklý seyirler göstermektedir. Klinik daha hafif seyirli olmakta ve yaþ, komorbid hastalýklar; ilaç etkileþimleri ve organ yetersizlikleri gibi nedenlerden dolayý tedavi seçenekleri kýsýtlanmaktadýr. Yaþlý popülasyonda Crohn Hastalýðý ile ilgili sinirli sayýda yayýn mevcuttur. Burada ülkemizden bu konu ile ilgili ilk verileri bildiriyoruz.
YÖNTEM ve GEREÇLER: Hastanemiz IBH polikliniðinde 1996 ve 2015 yýllarý arasýnda takip ve tedavi edilen toplam 3125 hastadan Crohn Hastalýðý tanýsý olan 95 hasta çalýsmaya alýndý. Veriler hasta kayýtlarý ve özel dosya sisteminden elde edilerek toplandý.
BULGULAR: Ortalama yas 66 ve K/E oraný 1.6 olarak saptandý. Hastalarýn %48.4'unde kolonik hastalýk, %37.9'unda ileokolonik tutulum ve %13.7'sinde sadece ince barsak tutulumu saptandý. Hastalarýn %23.1'inde cerrahi gereksinimi ki cogunlukla sag hemikolektomi ve ilerotransversostomi saptandý. Hastalarýn büyük cogunlugu mesalazin ve azatiyoprin almaktaydý. %12.6'sinda en sýk koroner arter hastalýðý olmak üzere 2 ya da daha fazla komorbid hastalýk bulunmaktaydý.
TARTIÞMA ve SONUÇ: Verilerimiz literatürde daha önce saptanan veriler ile paralellik göstermektedir. Bu yayýn ülkemizden geriatrik popülasyonda Crohn Hastalýðý ile ilgili olarak tatmin edici hasta sayýsý ile birlikte ilk veridir.