Remission From Ulcerative Colitis More Likely After 50
Older people treated for the disease do better than those diagnosed earlier, study finds
THURSDAY, August 5, 2010 (HealthDay News) -- People diagnosed with ulcerative colitis after age 50 are more likely to achieve symptom relief than people diagnosed at a younger age, even when they receive similar treatments, finds a new study.
Ulcerative colitis, which affects about one million American adults, involves inflammation of the lining of the large intestine or colon. It often causes diarrhea, bloody stool, weight loss and fever. Severe cases may require surgery to remove the colon.
The study included 295 patients treated at the inflammatory bowel disease clinics at the Washington University School of Medicine between 2001 and 2008. At the start, all patients were about equal in terms of the severity of their symptoms.
After one year of treatment, remission occurred in 64 percent of those who were diagnosed after age 50, compared to 49 percent of those diagnosed at a younger age.
Patients in remission may no longer have clinical symptoms of ulcerative colitis but may still have inflammation and may need to continue treatment with 5-aminosalicylate (5-ASA) drugs. However, they can discontinue immunosuppressive steroid treatment.
The study appears in the August issue of the journal Clinical Gastroenterology and Hepatology.
"The age at which patients are affected tends to split into two specific waves. In the clinic, we see a number of patients who get the disease from their late teens to their mid 20s. Then there's a second peak of patients who aren't affected until after the age of 50," lead investigator Dr. Matthew A. Ciorba, an assistant professor of medicine, said in a WUSM news release.
"We know from research by other investigators that as people age their immune systems tend to quiet down, and the results from our study reflect that findings," he noted. "Ulcerative colitis is driven by an over-active immune response in the gut, so it makes sense that people whose immune systems are less active might have better outcomes. Conversely, younger patients are more likely to have robust inflammatory responses, so their disease is harder to quiet down."
The U.S. National Institute of Diabetes and Digestive and Kidney Diseases has more about ulcerative colitis.