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P310. Late onset inflammatory bowel disease – View from a regional hospital

J. Dinis Silva, N. Veloso, I. Rosa, R. Godinho, I. Medeiros, L. Goncalves, C. Viveiros

Hospital Espírito Santo de Évora EPE, Évora, Portugal

Aim: Inflammatory bowel disease (IBD) is generally thought of as a disease that primarily affects young adults, although a second incidence peak can be seen between the ages of 50 and 80, with approximately 15% of the cases manifesting after 65 years. Despite the increase in the epidemiologic data in these age groups, many questions regarding the clinical manifestations and treatment remain unanswered. The purpose of our study was to compare the epidemiologic characteristics, clinical manifestations and response to treatment of all patients 65 years of age or older with younger patients seen at our institution.

Materials and Methods: This was a retrospective descriptive study that included patients diagnosed with IBD in our institution between January 2000 and December 2009. We collected data regarding diagnosis, disease location, extraintestinal manifestations, disease severity, need of surgery and medical treatment of patients that we then compared according to the age at diagnosis (65 years or older versus younger patients).

Results: Eighty-one patients were included in this study, 18 of them older than 65 years (22.2%). Thirteen of these had ulcerative colitis (UC) and 5 had Crohn's disease (CD). In our study population, those with IBD diagnosed at 65 years or older required less immunosuppression (P < 0.05) but had a higher usage of topical corticosteroids (P < 0.05). We also noted that those with UC diagnosed at 65 years or older were predominantly females (P < 0.05) and that younger patients with CD needed systemic corticosteroids more frequently (P < 0.05).

Conclusion: Our data suggest that late onset IBD is less severe, as shown by a lesser requirement of immunosuppression and more common use of topical therapy. Further research is needed to increase our understanding of the clinical characteristics and response to treatment of this important “older” group of patients with IBD.