The management of small bowel Crohn's disease in older age.

IF 2.5 3区医学 Q2 GASTROENTEROLOGY & HEPATOLOGY

Current Opinion in Gastroenterology Pub Date : 2025-09-01 Epub Date: 2025-07-30 DOI:10.1097/MOG.0000000000001126

Eathar Shakweh, Ailsa Hart

{"title":"The management of small bowel Crohn's disease in older age.","authors":"Eathar Shakweh, Ailsa Hart","doi":"10.1097/MOG.0000000000001126","DOIUrl":null,"url":null,"abstract":"Purpose of review: The prevalence of inflammatory bowel disease (IBD) amongst older adults (≥60 years old) is rising, encompassing individuals with a preexisting diagnosis and those newly diagnosed. Projections estimate that by 2030, one-third of patients with IBD will be older adults. Managing older adults with IBD poses unique challenges, including frailty, multimorbidity and polypharmacy. This review summarises the approach to managing older adults with small bowel Crohn's disease (SBCD), a distinct IBD sub-type.Recent findings: The 2024 \"State of IBD care in the United Kingdom (UK)\" report revealed a median delay of 8 months from onset of Crohn's disease symptoms to diagnosis. Diagnostic delay in Crohn's disease is associated with stricturing and penetrating complications. Diagnostic challenges in SBCD include its insidious presentation in older adults and the poor utility of calprotectin as a biomarker, with a positive predictive value of only 23.1% with a calprotectin over 200 μg/g. Management should be tailored to patient preference and frailty, given the paucity of evidence pertaining to nutritional, medical and surgical treatment approaches in older adults.Summary: Older adults with IBD represent a heterogenous cohort. Optimising the recruitment of older adults to clinical trials and stratifying outcomes according to frailty are key research priorities.","PeriodicalId":50607,"journal":{"name":"Current Opinion in Gastroenterology","volume":" ","pages":"369-376"},"PeriodicalIF":2.5000,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Current Opinion in Gastroenterology","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1097/MOG.0000000000001126","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2025/7/30 0:00:00","PubModel":"Epub","JCR":"Q2","JCRName":"GASTROENTEROLOGY & HEPATOLOGY","Score":null,"Total":0}

引用次数: 0

Abstract

Purpose of review: The prevalence of inflammatory bowel disease (IBD) amongst older adults (≥60 years old) is rising, encompassing individuals with a preexisting diagnosis and those newly diagnosed. Projections estimate that by 2030, one-third of patients with IBD will be older adults. Managing older adults with IBD poses unique challenges, including frailty, multimorbidity and polypharmacy. This review summarises the approach to managing older adults with small bowel Crohn's disease (SBCD), a distinct IBD sub-type.

Recent findings: The 2024 "State of IBD care in the United Kingdom (UK)" report revealed a median delay of 8 months from onset of Crohn's disease symptoms to diagnosis. Diagnostic delay in Crohn's disease is associated with stricturing and penetrating complications. Diagnostic challenges in SBCD include its insidious presentation in older adults and the poor utility of calprotectin as a biomarker, with a positive predictive value of only 23.1% with a calprotectin over 200 μg/g. Management should be tailored to patient preference and frailty, given the paucity of evidence pertaining to nutritional, medical and surgical treatment approaches in older adults.

Summary: Older adults with IBD represent a heterogenous cohort. Optimising the recruitment of older adults to clinical trials and stratifying outcomes according to frailty are key research priorities.

查看原文本刊更多论文

老年小肠克罗恩病的治疗

综述目的：炎症性肠病（IBD）在老年人（≥60岁）中的患病率正在上升，包括已有诊断和新诊断的个体。据预测，到2030年，三分之一的IBD患者将是老年人。管理老年IBD患者面临着独特的挑战，包括虚弱、多病和多种药物。这篇综述总结了管理老年人小肠克罗恩病（SBCD）的方法，这是一种独特的IBD亚型。最新发现：2024年“英国IBD护理状况”报告显示，从克罗恩病症状发作到诊断的中位延迟为8个月。克罗恩病的诊断延迟与狭窄和穿透并发症有关。SBCD的诊断挑战包括其在老年人中的隐匿性表现和钙保护蛋白作为生物标志物的不良效用，钙保护蛋白超过200 μg/g时阳性预测值仅为23.1%。鉴于缺乏有关老年人营养、医疗和手术治疗方法的证据，管理应根据患者的偏好和虚弱程度量身定制。总结：老年IBD患者是一个异质性队列。优化老年人临床试验的招募和根据虚弱程度对结果进行分层是关键的研究重点。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文求助全文

来源期刊

Current Opinion in Gastroenterology 医学-胃肠肝病学

CiteScore

5.30

自引率

0.00%

发文量

137

审稿时长

6-12 weeks

期刊介绍： Published bimonthly and offering a unique and wide ranging perspective on the key developments in the field, each issue of Current Opinion in Gastroenterology features hand-picked review articles from our team of expert editors. With twelve disciplines published across the year – including gastrointestinal infections, nutrition and inflammatory bowel disease – every issue also contains annotated references detailing the merits of the most important papers.