Ulcerative colitis (UC) among older adults is becoming more and more common. Geriatric UC can emerge at an older age, or it can start when someone is younger and continue throughout their life.
This information comes from a study published in Digestion: International Journal of Gastroenterology.
When older people develop UC, they usually do not have a family history of the condition. Instead, over time, they have experienced changes in their intestinal microbiota.
These changes in microbiota — coupled with a weaker immune system — may place older people at a greater risk of developing UC.
Although geriatric UC is becoming more common, experts think this may be because people are living longer.
Read on to learn about what geriatric UC is, its treatment, and why cases are rising.
Geriatric UC is a term describing the condition when it presents in someone over the age of 60.
UC is a form of inflammatory bowel disease (IBD). When a person has UC, they
Some people with geriatric UC may have received a diagnosis when they were younger, and as they have grown older, the condition has persisted. In other people, UC develops later in life.
According to one 2017 review, 15% of older IBD patients receive their diagnosis after the age of 60. Older adult males have higher rates of diagnosis than older adult females.
While this difference may be because IBD is more common in older males, it may also be because they are less likely to contact a doctor about their symptoms. UC is harder to diagnose in older adults. People may wait up to 6 years for a doctor to confirm the condition.
Symptoms of UC in older people are also slightly different compared to symptoms in younger people. For example, older people
The condition is also more likely to remain stable, and people are less likely to relapse and have serious flares.
People generally develop IBD, which includes UC and Crohn’s disease, when they are
However, as people age further, they are less likely to be diagnosed. As few as 10% of people ages 80 years and older go on to be diagnosed with IBD.
Typical symptoms of a UC flare
- blood in stool
- rectal bleeding
- cramping and pain in the abdomen
- constantly feeling the urge to go to the bathroom
- sudden onset of bowel movements
While UC symptoms are similar between age groups, older people usually experience less severe diarrhea, weight loss, and abdominal pain.
However, they are more likely to develop other complications,
- canker sores
- sores on shins (erythema nodosum)
- inflammation of the eye and eyelid (episcleritis)
- arthritis that affects four or fewer joints (pauciarticular arthritis)
- inflammatory arthritis of the spine (ankylosing spondylitis)
UC in older adults is more consistent, and they are less likely to have relapses. However, when a relapse does occur, it is usually more severe.
When an older person receives a UC diagnosis, a doctor will first prescribe medication to keep their symptoms under control and prevent flares from recurring.
To treat UC in older people, a doctor
- immune modulator therapy
However, many older people already take medication for other conditions. A doctor should consider any drug interactions that could occur.
When an older person has UC, they can develop several complications.
Some of these complications
For example, a person may develop chronic canker sores in the mouth or experience inflammation in the eyelids.
Other UC complications
However, older people with UC
Having two or more coexisting conditions means doctors need to consider the best treatment options. For example, they should be careful with the use of immunosuppressant drugs in older people with compromised immune systems.
There are several factors that could explain why the incidence of UC is increasing in the older population.
Cases may be increasing because doctors are better able to diagnose UC. Cases of UC in older populations are increasing at a faster rate in higher-income urbanized environments, so better access to healthcare can partially explain this phenomenon.
However, people who live in cities and densely populated towns also tend to eat a more westernized diet, which is high in saturated fat and refined carbohydrates. When people routinely eat these types of foods, they disturb their microbiota and
Other environmental factors that can increase a person’s UC risk include air pollution, lack of sleep and exercise, and high stress levels.
When an older person has UC, the goal of treatment is to keep them in remission as long as possible to prevent complications.
Many older adults are on medication for other conditions, so treatment should consider possible drug interactions.