Inflammatory bowel disease in the elderly: How are they identified?
In Israel, more than 50,000 patients live with inflammatory bowel disease. 20% of them, ie about 10,000 patients aged 65 and over, with a third of them, being newly diagnosed. Inflammatory bowel diseases are very diverse and vary in the nature and course of the disease between patients. The diversity and diversity is also evident in the older age group.We live in a world that requires reference to diversity. The personal and functional ability of a 10-year-old boy is different from a 15-year-old boy and a 25-year-old young man.

The main variability in adults stems from the background morbidity that characterizes this age group, for example, hypertension, diabetes, heart disease and more. This is a relatively broad age group, and in practice the treatment of those aged 65 and over is completely different from that of those aged 85 and over, a heterogeneous group with a different profile of background diseases, functional problems and therapeutic goals.

The duration of the disease is another point to pay attention to. A significant proportion of older patients with a long-standing illness that moderates over time and becomes calmer and less turbulent.

Diseases of the age or inflammatory bowel diseases?

There are symptoms that are related to the aging process, such as disorders of the digestive system and a tendency to constipation, or diarrhea. Degenerative changes and joint pain, not related to inflammatory bowel disease, but to aging of the body. The symptoms of these diseases can be confusing as they are similar to the inflammatory disease itself.

It is advisable to discern what the symptoms are related to, use diagnostic tools, and not give anti-inflammatory overdose to a non-inflammatory condition, or avoid treating inflammatory bowel symptoms. It is very important that even in older ages the goals be set in partnership with the patient and his support system, so that adherence and adherence to the treatment plan is optimal and tailored to the patient’s needs and desires, and allows for optimal quality of life.

An older patient in a changing reality

In the last two or three years, even following the Corona plague, the elderly population has had to learn to use technological means, such as telemedicine (telemedicine) which allows for comfort, accessibility and availability, and solves mobility and hassle problems. Even with the use of remote medicine, we have all the tools at our disposal to improve the condition of patients and avoid chronic suffering.

My recommendation to the older group, which seeks to control symptoms, live a maximum quality of life and avoid complications, is to continue monitoring and treating multidisciplinary centers. It is advisable to address all related issues, and receive appropriate treatment from the multidisciplinary team available to them. In addition to physicians, the multidisciplinary team for the treatment of inflammatory bowel disease includes a coordinating nurse, pelvic floor physiotherapist, psychologist / social worker who cares about the emotional side, welfare and welfare and experts from other fields.

I am glad that the World Organization has chosen inflammatory bowel disease in old age as a topic for promotion. This is a very important issue, which does not get enough expression and stage. This is a population with comorbidities associated with advanced age, physiological, social, and behavioral changes associated with aging. These make daily functioning difficult and add to dealing with inflammatory bowel disease. Awareness, advancement and technology provide us with a diverse and multidisciplinary treatment basket, enabling a broad and customized response, taking into account the difficulties and special characteristics, also, of the elderly patients. I sincerely hope that the stage given to this issue will lead to increased attention and comprehensive treatment that recognizes the importance of quality of life and well-being of patients, even in old age.

Dr. Hanit Yanai, director of the Center for Inflammatory Bowel Diseases at Beilinson Hospital

By Editor

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