Inflammatory bowel disease in the elderly patient.

Studies of inflammatory bowel disease (IBD) undertaken in the 1960s reported a highly unfavourable course and prognosis in patients over the age of 60 years. However, recent surveys have suggested that the pattern of IBD in the elderly patient is similar to the overall pattern of disease in other age groups. We have, therefore, reviewed data relating to 2657 patients from the OMGE series with particular reference to the pattern of disease in 244 patients (9.1% of the total group) aged over 60 years at the time of registration into the survey. The course and outcome of disease in these 244 patients were similar to other age groups in terms of response to therapy, major complications, and rate of recourse to surgery. However, the death rate in the elderly (2.4%) was higher than that in younger patients (0.8%). We concur with recent studies that the course of IBD is now more favourable in elderly patients than hitherto suspected. The cause is probably multifactorial, involving both a change in therapy and a change in the natural history of the disease.