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P661. Clinical characteristics of inflammatory bowel disease in elderly patients

J. Cadilla1, R. Ferreiro2, V. Ollero3, P. Vega4, A. Fernandez5, L. Sanromán1, E. Castro6, S. Soto4, J.R. Pineda1, A. Lorenzo2, A. Echarri3, V. Hernandez1, D. Carpio7, S. Pereira1, J. Castro3, M. Barreiro-de Acosta2, 1CHUVI, Spain, 2University Hospital, Gastroenterology, Santiago, Spain, 3Arquitecto Marcide, Ferrol, Spain, 4CHOU, Spain, 5Povisa, Spain, 6Hospital Lucus Augusti, Lugo, Spain, 7CHOP, Spain

Background

The gradual ageing of the Galician population is a fact that has been observed in recent years. In 1930, 16.1% of the population was over 65 years old and in 2010 these figures had increased to nearly 23%. Every year the number of patients diagnosed with inflammatory bowel disease (IBD) at more advanced ages has been increasing. The aim of the study was to assess the clinical characteristics of IBD patients that were diagnosed at advanced ages.

Methods

A Retrospective observational study was performed by IBD specialists from 7 Hospitals belonging to EIGA (The Galician Association for Research into Inflammatory Bowel Disease). The inclusion criteria were all IBD patients that had been diagnosed over 60 years of age. Epidemiological characteristics like classification of disease in accordance with the Montreal classification, gender, family history of IBD, use of steroids, immunosuppressive or biological drugs and need for surgery were performed. The results are shown in percentages.

Results

252 IBD patients were included: 162 (64.2%) with ulcerative colitis (UC) and 90 (35.8%) with Crohn's disease (CD). Regarding UC patients, 64% were male, and 96% had no family history of IBD. 29% of patients were older than 70 years of age at diagnosis. In accordance with the Montreal classification, 35.8% were E1, 46% E2 and 17.8% E3. In patients diagnosed between 60 and 70 years old, E2 (46.2%) was more frequent, but in patients over 70 years old, the most frequent extensions were E2 (46.35%) and E1 (43.6%). 30% needed steroids, developing 9.8% steroid-dependency; immunosuppressive drugs were needed for 11.7% and biological drugs for 3.7%. Only 2.4% of the patients required colectomy. Among CD patients, 56% were male, and 98% had no family history of IBD. 51% of patients were older than 70 years of age at diagnosis. In accordance with the Montreal classification, the most common location was L1 (48.8%). 57.7% of the patients presented B1 phenotype; 24.4% B2 and 16.6% B3. Perianal disease was present in 11.1% of CD patients. 52.2% needed steroids, developing 18.8% steroid-dependency; immunosuppressive drugs were needed for 26.6% (in all with perianal disease) and biological drugs for 13.3%. CD surgery was required for 18.8%.

Conclusion

In elderly IBD patients, UC seems to be more common than CD. Most cases of UC are limited to left side colitis and the need for aggressive therapies is very limited. CD patients who develop perianal disease should be given immunosuppressive or biological drugs.