Inflammatory Bowel Disease (IBD) consists of two distinct situations namely ulcerative colitis (UC) and Crohn’s disease (CD) with largely common etiopathogenesis, clinical behavior, and treatment strategies. However, the disease is running a different clinical course at various ages. For example, the course of IBD in the elderly is characterized by increased susceptibility to infections. The appearance of colorectal cancer (CRC) is a well-known complication of IBD. The available guidelines recommend that patients with UC diagnosed with CRC undergo total proctocolectomy with or without Ileoanal pouch anastomosis (IAPA) and that patients with CD and CRC undergo either total colectomy or proctocolectomy. Segmental colectomy, however, may be considered in selected older patients with IAPA and CRC with short disease duration. Vaccination is inviolable in all patients aged 60 years and older. Polypharmacy is very common in elderly IBD patients which may lead to drug interactions. It is therefore necessary to identify the mechanisms of interaction with IBD drugs used in IBD patients and to develop strategies to minimize them. The role of systemic and mucosal immune aging and the dysbiotic microbial ecosystem in the pathophysiology of IBD in the elderly is of great importance. The role of nutritional deficiencies is quite important. Specific guidelines regarding the conservative and surgical management of elderly IBD patients should be a forthcoming goal to improve outcomes in adult IBD patients.
The goal of this Research Topic is to bring together recent data on the clinical behavior of IBD in the elderly, the changing epidemiology of the disease across countries, improvements in the diagnostic methodology, and age-related differences in treatment strategies. The problem of colorectal cancer and precancerous conditions in patients of this age is also important. The articles included in this Research Topic are expected to provide answers related to several problems faced daily and appearing in older adults with IBD.
Below are some indicative examples of certain issues that could be included in this Research Topic.
•Epidemiological aspects of IBD in the elderly
•Polypharmacy in the elderly: prevalence, impact, pharmacological interactions
•Immunological responses in the elderly: implications for disease pathophysiology
•Risk of chronic diseases in older adults with IBD
•Infections (viral, microbial, TBC, etc) in older adults with IBD
•Indications and safety of newer IBD treatment.
•Biologic and micromolecular agents: safety and treatment results
•Nutritional support in elderly patients with IBD
•Surgical treatment of IBD in older adults
•Post-surgical complications
•CRC in elderly patients with IBD
•Surveillance for malignancy in elderly patients with IBD.
Articles may be original papers, systematic reviews and/or meta-analyses, descriptions of interesting cases or patient series, and therapeutic trials.
Keywords:
Epidemiology, Ulcerative Colitis, Crohn's Disease, Medical Treatment, Surgical Treatment
Important Note:
All contributions to this Research Topic must be within the scope of the section and journal to which they are submitted, as defined in their mission statements. Frontiers reserves the right to guide an out-of-scope manuscript to a more suitable section or journal at any stage of peer review.
Inflammatory Bowel Disease (IBD) consists of two distinct situations namely ulcerative colitis (UC) and Crohn’s disease (CD) with largely common etiopathogenesis, clinical behavior, and treatment strategies. However, the disease is running a different clinical course at various ages. For example, the course of IBD in the elderly is characterized by increased susceptibility to infections. The appearance of colorectal cancer (CRC) is a well-known complication of IBD. The available guidelines recommend that patients with UC diagnosed with CRC undergo total proctocolectomy with or without Ileoanal pouch anastomosis (IAPA) and that patients with CD and CRC undergo either total colectomy or proctocolectomy. Segmental colectomy, however, may be considered in selected older patients with IAPA and CRC with short disease duration. Vaccination is inviolable in all patients aged 60 years and older. Polypharmacy is very common in elderly IBD patients which may lead to drug interactions. It is therefore necessary to identify the mechanisms of interaction with IBD drugs used in IBD patients and to develop strategies to minimize them. The role of systemic and mucosal immune aging and the dysbiotic microbial ecosystem in the pathophysiology of IBD in the elderly is of great importance. The role of nutritional deficiencies is quite important. Specific guidelines regarding the conservative and surgical management of elderly IBD patients should be a forthcoming goal to improve outcomes in adult IBD patients.
The goal of this Research Topic is to bring together recent data on the clinical behavior of IBD in the elderly, the changing epidemiology of the disease across countries, improvements in the diagnostic methodology, and age-related differences in treatment strategies. The problem of colorectal cancer and precancerous conditions in patients of this age is also important. The articles included in this Research Topic are expected to provide answers related to several problems faced daily and appearing in older adults with IBD.
Below are some indicative examples of certain issues that could be included in this Research Topic.
•Epidemiological aspects of IBD in the elderly
•Polypharmacy in the elderly: prevalence, impact, pharmacological interactions
•Immunological responses in the elderly: implications for disease pathophysiology
•Risk of chronic diseases in older adults with IBD
•Infections (viral, microbial, TBC, etc) in older adults with IBD
•Indications and safety of newer IBD treatment.
•Biologic and micromolecular agents: safety and treatment results
•Nutritional support in elderly patients with IBD
•Surgical treatment of IBD in older adults
•Post-surgical complications
•CRC in elderly patients with IBD
•Surveillance for malignancy in elderly patients with IBD.
Articles may be original papers, systematic reviews and/or meta-analyses, descriptions of interesting cases or patient series, and therapeutic trials.
Keywords:
Epidemiology, Ulcerative Colitis, Crohn's Disease, Medical Treatment, Surgical Treatment
Important Note:
All contributions to this Research Topic must be within the scope of the section and journal to which they are submitted, as defined in their mission statements. Frontiers reserves the right to guide an out-of-scope manuscript to a more suitable section or journal at any stage of peer review.