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Original Article

IBD

Clinical spectrum of elderly-onset inflammatory bowel disease in India: Yogesh Kumar Gupta, Arshdeep Singh, Vikram Narang, Vandana Midha, Ramit Mahajan, Varun Mehta, Dharmatma Singh, Namita Bansal, Madeline Vithya Barnaba Durairaj, Amit Kumar Dutta, Ajit Sood; Intest Res 2023;21(2):216-225. Published online August 8, 2022; DOI: https://doi.org/10.5217/ir.2021.00177

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Background/Aims
Inflammatory bowel disease (IBD) is increasingly being recognized in elderly patients. Data on clinical spectrum of elderly-onset IBD patients is lacking from India.
Methods
A cross-sectional retrospective analysis of a prospectively maintained database of patients diagnosed with IBD was conducted at 2 centers in India. The clinical spectrum of elderly-onset IBD including demographic profile (age and sex), clinical presentation, disease characteristics (disease behavior and severity, extent of disease), and treatment were recorded and compared with adult-onset IBD.
Results
During the study period, 3,922 (3,172 ulcerative colitis [UC] and 750 Crohn’s disease [CD]) patients with IBD were recorded in the database. A total of 186 patients (4.74%; 116 males [62.36%]) had elderly-onset IBD (69.35% UC and 30.64% CD). Diarrhea, blood in stools, nocturnal frequency and pain abdomen were the commonest presentations for UC, whereas pain abdomen, weight loss and diarrhea were the most frequent symptoms in CD. For both elderly onset UC and CD, majority of the patients had moderately severe disease. Left-sided colitis was the commonest disease location in UC. Isolated ileal disease and inflammatory behavior were the most common disease location and behavior, respectively in CD. 5-Aminosalicylates were the commonest prescribed drug for both elderly onset UC and CD. Thiopurines and biologics were used infrequently. Prevalence of colorectal cancer was higher in elderly onset IBD.
Conclusions
Elderly onset IBD is not uncommon in India. Both the elderly onset UC and CD were milder, with no significant differences in disease characteristics (disease extent, location and behavior) when compared to adult-onset IBD. Colorectal cancer was more common in elderly onset IBD.

Citations

Citations to this article as recorded by

Current approaches to managing inflammatory bowel disease in the elderly – A literature review
Maciej Zamorski, Agata Stebel, Alicja Gładysz
Annales Academiae Medicae Silesiensis.2026; 80: 155. CrossRef
Clinical characteristics and treatment patterns of older and younger patients with inflammatory bowel disease
Fatih Kivrakoglu, Vedat Kilic, Mustafa Ergin, Harun Kucuk, Cagdas Erdogan, Ilhami Yuksel
World Journal of Gastroenterology.2026;[Epub] CrossRef
Inflammatory bowel disease in south Asia: a scoping review
Shabari Shenoy, Anuraag Jena, Carrie Levinson, Vishal Sharma, Parakkal Deepak, Tina Aswani-Omprakash, Shaji Sebastian, Jean-Frederic Colombel, Manasi Agrawal
The Lancet Gastroenterology & Hepatology.2025; 10(3): 259. CrossRef
Metabolic Disorders and Inflammatory Bowel Diseases
Hye Kyung Hyun, Jae Hee Cheon
Gut and Liver.2025; 19(3): 307. CrossRef
Elderly-onset inflammatory bowel disease in Asia: clinical characteristics and therapeutic strategies
Jiyoung Yoon, Daein Kim, You Sun Kim
Intestinal Research.2025; 23(4): 430. CrossRef
Inflammatory Bowel Disease in the Elderly
Rachid El Jim, Chaimae Maroute, Asmae Lamine, Maria Lahlali, Hakima Abid, Nada Lahmidani, Amine El Mekkaoui, Mounia El Yousfi, Dafr-Allah Benajah, Sidi Adil Ibrahimi, Mohammed El Abkari
Open Journal of Gastroenterology.2025; 15(07): 376. CrossRef
Impact of age at diagnosis on long‐term prognosis in patients with intestinal Behçet's disease
Ji Young Chang, Soo Jung Park, Jae Jun Park, Tae Il Kim, Jae Hee Cheon, Jihye Park
Journal of Gastroenterology and Hepatology.2024; 39(3): 519. CrossRef
Neither hepatic steatosis nor fibrosis is associated with clinical outcomes in patients with intestinal Behçet’s disease
Hye Kyung Hyun, Jihye Park, Soo Jung Park, Jae Jun Park, Tae Il Kim, Jae Seung Lee, Hye Won Lee, Beom Kyung Kim, Jun Yong Park, Do Young Kim, Sang Hoon Ahn, Seung Up Kim, Jae Hee Cheon
European Journal of Gastroenterology & Hepatology.2024; 36(4): 445. CrossRef
Inflammatory bowel disease: a narrative review of disease evolution in South Asia and India over the last decade
Sahana Shankar, Snehali Majumder, Suparna Mukherjee, Anirban Bhaduri, Rangarajan Kasturi, Subrata Ghosh, Marietta Iacucci, Uday N. Shivaji
Therapeutic Advances in Gastroenterology.2024;[Epub] CrossRef
A prospective study of inflammatory bowel disease phenotypes in extremes of age and comparison with adults
Nikhil Bhangale, Devendra Desai, Philip Abraham, Tarun Gupta, Pavan Dhoble, Anand Joshi
Indian Journal of Gastroenterology.2023; 42(3): 404. CrossRef
Global Epidemiology and Burden of Elderly-Onset Inflammatory Bowel Disease: A Decade in Review
Pojsakorn Danpanichkul, Kanokphong Suparan, Suchapa Arayakarnkul, Aunchalee Jaroenlapnopparat, Natchaya Polpichai, Panisara Fangsaard, Siwanart Kongarin, Karan Srisurapanont, Banthoon Sukphutanan, Wasuwit Wanchaitanawong, Yatawee Kanjanakot, Jakrapun Pupa
Journal of Clinical Medicine.2023; 12(15): 5142. CrossRef

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Case Report

Fatal infections in older patients with inflammatory bowel disease on anti-tumor necrosis factor therapy: Way-Seah Lee, Najib Azmi, Ruey-Terng Ng, Sik-Yong Ong, Sasheela Sri La Ponnampalavanar, Sanjiv Mahadeva, Ida Hilmi; Intest Res 2017;15(4):524-528. Published online October 23, 2017; DOI: https://doi.org/10.5217/ir.2017.15.4.524

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Anti-tumor necrosis factor (anti-TNF) is highly effective in inflammatory bowel disease (IBD); however, it is associated with an increased risk of infections, particularly in older adults. We reviewed 349 patients with IBD, who were observed over a 12-month period, 74 of whom had received anti-TNF therapy (71 patients were aged <60 years and 3 were aged ≥60 years). All the 3 older patients developed serious infectious complications after receiving anti-TNFs, although all of them were also on concomitant immunosuppressive therapy. One patient developed disseminated tuberculosis, another patient developed cholera diarrhea followed by nosocomial pneumonia, while the third patient developed multiple opportunistic infections (Pneumocystis pneumonia, cryptococcal septicemia and meningitis, Klebsiella septicemia). All 3 patients died within 1 year from the onset of the infection(s). We recommend that anti-TNF, especially when combined with other immunosuppressive therapy, should be used with extreme caution in older adult patients with IBD.

Citations

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Infection toxicity assessment of tumor necrosis factor α inhibitors in the treatment of IBD: a real-world study based on the US food and drug administration adverse events reporting system (FAERS)
Qian Cheng, Zeyu Yao, Xuan Shi, Shupeng Zou, Yazheng Zhao, Mengling Ouyang, Minghui Sun
Expert Opinion on Drug Safety.2026; 25(10): 2007. CrossRef
Elderly-onset inflammatory bowel disease in Asia: clinical characteristics and therapeutic strategies
Jiyoung Yoon, Daein Kim, You Sun Kim
Intestinal Research.2025; 23(4): 430. CrossRef
RATE OF INFECTION (TUBERCULOSIS) IN BRAZILIANS IBD PRIVATE PATIENTS: FOLLOW-UP 15 YEARS
Didia B CURY, Liana C B CURY, Ana C MICHELETTI, Rogério A OLIVEIRA, José J S GONÇALVES
Arquivos de Gastroenterologia.2024;[Epub] CrossRef
Cryptococcosis Associated With Biologic Therapy: A Narrative Review
Xin Li, Olivier Paccoud, Koon-Ho Chan, Kwok-Yung Yuen, Romain Manchon, Fanny Lanternier, Monica A Slavin, Frank L van de Veerdonk, Tihana Bicanic, Olivier Lortholary
Open Forum Infectious Diseases.2024;[Epub] CrossRef
Inflammatory bowel disease complicated with rare pathogen infection
Jia-Heng Fang, Guo-Xiong Li
World Chinese Journal of Digestology.2023; 31(1): 8. CrossRef
Pulmonary cryptococcosis after immunomodulator treatment in patients with Crohn’s disease: Three case reports
Yan-Fei Fang, Xiang-Han Cao, Ling-Ya Yao, Qian Cao
World Journal of Gastroenterology.2023; 29(4): 758. CrossRef
Systemic lupus erythematosus complicated by Crohn’s disease with rectovaginal fistula
Heng Yeh, Ren-Chin Wu, Wen-Sy Tsai, Chia-Jung Kuo, Ming-Yao Su, Cheng-Tang Chiu, Puo-Hsien Le
BMC Gastroenterology.2021;[Epub] CrossRef
Systematic review with meta‐analysis: biologics and risk of infection or cancer in elderly patients with inflammatory bowel disease
Daniele Piovani, Silvio Danese, Laurent Peyrin‐Biroulet, Georgios K. Nikolopoulos, Stefanos Bonovas
Alimentary Pharmacology & Therapeutics.2020; 51(9): 820. CrossRef
Safety of Biologic Therapy in Older Patients With Immune-Mediated Diseases: A Systematic Review and Meta-analysis
Nienke Z. Borren, Ashwin N. Ananthakrishnan
Clinical Gastroenterology and Hepatology.2019; 17(9): 1736. CrossRef
Improving Quality in the Care of Patients with Inflammatory Bowel Diseases
Matthew D Egberg, Ajay S Gulati, Ziad F Gellad, Gil Y Melmed, Michael D Kappelman
Inflammatory Bowel Diseases.2018; 24(8): 1660. CrossRef

9,087 View
96 Download
8 Web of Science
10 Crossref

Original Article

Double-Balloon Enteroscopy in Elderly Patients: Is It Safe and Useful?: Dae Han Choi, Seong Ran Jeon, Jin-Oh Kim, Hyun Gun Kim, Tae Hee Lee, Woong Cheul Lee, Byung Soo Kang, Jun-Hyung Cho, Yunho Jung, Wan Jung Kim, Bong Min Ko, Joo Young Cho, Joon Seong Lee, Moon Sung Lee; Intest Res 2014;12(4):313-319. Published online October 27, 2014; DOI: https://doi.org/10.5217/ir.2014.12.4.313

Abstract PDF PubReader ePub

<b>Background/Aims</b><br/>

Providers may be hesitant to perform double-balloon enteroscopy (DBE) in the elderly because the increased number of co-morbidities in this population poses a greater risk of complications resulting from sedation. There are limited data on the use of DBE in the elderly. Here, we assessed the safety and efficacy of DBE in the elderly compared to those in younger patients.

Methods

We retrospectively analyzed the medical records of 158 patients who underwent 218 DBEs. Patients were divided into an elderly group (age ≥65 years; mean 71.4±5.4; n=34; 41 DBEs) and a younger group (age <65 years; mean 39.5±13.5; n=124; 177 DBEs).

Results

In both groups, the most common indication for DBE was obscure gastrointestinal bleeding. Mucosal lesions (33.3% vs. 60.9%; P=0.002) were the most common finding in both groups, followed by tumors (30.8% vs. 14.1%; P=0.036). The elderly were more likely to receive interventional therapy (51.3% vs. 23.5%; P=0.001). The diagnostic yield of DBE was slightly higher in the elderly group (92.3% vs. 86.5%; P=0.422), but was not statistically significant. The therapeutic success rate of DBE was 100% in the elderly group compared to 87.5% in the younger group (P=0.536). The overall DBE complication rate was 1.8% overall, and this rate did not differ significantly between the groups (2.6% vs. 1.7%; P=0.548).

Conclusions

DBE is safe and effective in the elderly, and has a high diagnostic yield and high therapeutic success rate.

Citations

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