Crohn's disease in the elderly: clinical features and long-term outcome of 19 Greek patients.

AIM: To study the clinical course, prognosis, treatment and follow-up of 19 patients with Crohn's disease aged 60 years or over at the time of onset of symptoms. PATIENTS AND METHODS: A series of 12 males and 7 females aged 65 +/- 4. 9 and 66. 6 +/- 6 years at the onset of symptoms and the time of diagnosis, respectively (elderly group), were studied. Another group of patients(83 males, 53 females aged 29.8 +/- 12.4 and 32.2 +/- 12.7 at the onset of symptoms and of diagnosis, respectively) served as a control group (young group). Both groups were followed-up for a mean period of 7.2 and 9.8 years, respectively. RESULTS: The most common site of involvement in the elderly group was the distal ileum (47.4%), followed by large bowel (36.6%) and concurrent large and small bowel involvement (16%). Acute presentation was significantly more common in the older group. Fever and loss of weight were significantly less common in the older group (p<0.05). A higher rate of complications especially acute abdomen, was observed in the elderly group. There were no significant differences in the indication for surgery and type of surgical procedure applied between the two groups. However significantly fewer patients in the elderly group were operated on because of perianal abscess compared to the young group (p<0.05). Follow-up data revealed that elderly patients with Crohn's disease who had been operated upon showed no significant differences in the course of their disease compared to operated young patients. CONCLUSION: Crohn's disease in elderly persons of Greek origin follows much the same pattern as in other developed countries of the world.

Surgery for ulcerative colitis in Greece: clinicoepidemiological features and long-term outcome of 69 consecutive patients.

BACKGROUND/AIMS: In this study, the various clinicoepidemiological characteristics and long-term follow-up of patients operated on for ulcerative colitis in Greece over a period of 15 years, are reviewed. METHODOLOGY: A total number of 69 out of 413 patients with ulcerative colitis (17.8%) seen and followed-up for a mean period of 12 years, had undergone ileorectal anastomosis (45.6%), total proctocolectomy with permanent ileostomy (35.6%), ileal-anal pouch anastomosis (17.6%) and Kock ileostomy (1.5%), mainly for bad response to conservative treatment (78.3%). Other causes for operation were large bowel cancer (8.7%), profound hemorrhage (4.3%), toxic megacolon (1.4%), and rectovaginal fistula (1.4%). Almost half of the operations (45%) were performed between the first and fourth year after the establishment of diagnosis. RESULTS: A number of statistically highly significant differences between the operated and non-operated group of patients were noticed. So, patients operated on had more extensive disease in comparison with non-operated ones and were younger at the time of diagnosis. The overall perioperative morbidity and mortality were 6% and 5% respectively. Survival was not statistically significantly different between operated and non-operated patients and also did not differ significantly between men and women. Most of the deaths in the operated and non-operated group of patients were unrelated to ulcerative colitis. CONCLUSION: It is concluded that the clinicoepidemiological features and outcome of the Greek patients operated on for ulcerative colitis have similarities with those reported from other developed countries of the world.