[Inflammatory bowel disease in three elderly patients; an unexpected diagnosis in long-standing abdominal complaints]

Abstract

Three female patients, 68, 75 and 68 years of age, were treated symptomatically for long-standing abdominal complaints such as gastralgia, diarrhoea and loss of blood or mucus with the stools. In all cases there was no clear diagnosis and treatment did not relieve the complaints, even after surgery. Inflammatory bowel disease was ultimately established on the basis of histological analysis of both resection specimens and biopsies in combination with endoscopy. Clinical improvement was achieved after adequate treatment. Aspecific abdominal complaints in elderly patients have multiple differential diagnoses. The most important of these are diverticulitis, ischaemia and colon carcinoma. In contrast, inflammatory bowel disease (both Crohn's disease and ulcerative colitis) is usually diagnosed at a younger age. Ignoring inflammatory bowel disease as a cause of abdominal complaints in elderly patients could be responsible for inadequate treatment, higher morbidity and an increase of symptoms.