Retrospective analysis of old-age colitis in the Dutch inflammatory bowel disease population.
OBJECTIVE
To describe the characteristics of Dutch patients with chronic inflammatory bowel disease (IBD) first diagnosed above 60 years of age-a disease also known as old-age colitis (OAC) and to highlight a condition that has a similar appearance to IBD, namely segmental colitis associated with diverticular disease (SCAD).


METHODS
A retrospective longitudinal survey of patient demographic and clinical characteristics, disease characteristics, diagnostic methods, management and course of disease was performed. The median follow-up period was 10 years.


RESULTS
Of a total of 1100 IBD patients attending the Department of Gastroenterology, 59 (5%) [median age 82 years (range 64-101); 25 male (42%)] were identified. These patients were diagnosed with ulcerative colitis (n = 37, 61%), Crohn's disease (n = 14, 24%), and indeterminate colitis (n = 8, 15%). Remission was induced in 40 (68%) patients within a median interval of 6 mo (range 1-21) and immunosuppressive therapy was well tolerated. Histological evaluation based on many biopsy samples and the course of the disease led to other diagnosis, namely SCAD instead of IBD in five (8%) patients.


CONCLUSIONS
OAC is not an infrequent problem for the gastroenterologist, and should be considered in the evaluation of older patients with clinical features suggestive of IBD. Extra awareness and extensive biopsy sampling are required in order to avoid an erroneous diagnosis purely based on histological mimicry of changes seen in SCAD, when diagnosing IBD in the presence of diverticulosis coli.
Hadithi
Muhammed
M
Department of Gastroenterology, VUmc University Medical Center, Amsterdam, PO Box 7057, Amsterdam 1007 MB, The Netherlands.
Cazemier
Marcel
M
Meijer
Gerrit-A
GA
Bloemena
Elisabeth
E
Felt-Bersma
Richel-J
RJ
Mulder
Chris-J
CJ
Meuwissen
Stephan-Gm
SG
Pena
Amado-Salvador
AS
van Bodegraven
Adriaan-A
AA
D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D003092:Colitis / Q000453:epidemiology* / Q000473:pathology / Q000628:therapy; D003093:Colitis, Ulcerative / Q000453:epidemiology; D003113:Colonoscopy; D003424:Crohn Disease / Q000453:epidemiology; D003951:Diagnostic Errors / Q000517:prevention & control; D043963:Diverticulosis, Colonic / Q000453:epidemiology* / Q000473:pathology / Q000628:therapy; D005260:Female; D006801:Humans; D015212:Inflammatory Bowel Diseases / Q000453:epidemiology* / Q000473:pathology / Q000628:therapy; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D009426:Netherlands / Q000453:epidemiology; D012189:Retrospective Studies