Segal Jonathan P, Htet Hein Myat Thu, Limdi Jimmy, Hayee Bu'Hussain
Department of Gastroenterology, St Mark's Hospital, Watford, UK.
Gastroenterology, Barts Health NHS Trust, London, London, UK.
Frontline Gastroenterol. 2019 Nov 15;11(6):468-477. doi: 10.1136/flgastro-2019-101218. eCollection 2020 Oct.
As the incidence of inflammatory bowel disease (IBD) rises and the global population ages, the number of older people living with these conditions will inevitably increase. The challenges posed by comorbid conditions, polypharmacy, the unintended consequences of long-term treatment and the real but often underestimated mismatch between chronological and biological ages underpin management. Significantly, there may be differences in disease characteristics, presentation and management of an older patient with IBD, together with other unique challenges. Importantly, clinical trials often exclude older patients, so treatment decisions are frequently pragmatic, extrapolated from a number of sources of evidence and perhaps primarily dictated by concerns around adverse effects. This review aimed to discuss the epidemiology, clinical features and considerations with management in older patients with IBD.
随着炎症性肠病（IBD）发病率的上升以及全球人口老龄化，患有这些疾病的老年人数量将不可避免地增加。合并症、多种药物治疗、长期治疗的意外后果以及实际存在但常常被低估的生理年龄与实际年龄的不匹配给管理带来了挑战。值得注意的是，老年IBD患者在疾病特征、表现和管理方面可能存在差异，同时还有其他独特的挑战。重要的是，临床试验通常将老年患者排除在外，因此治疗决策往往是务实的，从多种证据来源推断而来，并且可能主要由对不良反应的担忧所决定。本综述旨在讨论老年IBD患者的流行病学、临床特征及管理方面的考量。
