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Colitis patients diagnosed later in life tend to have better disease outcomes
Date:8/2/2010

tis patients have inflammation only in the lining of the large intestine or colon. The condition often causes diarrhea, bloody stool, weight loss and fever. In severe cases, some patients need surgery to remove the colon.

"At the start of the study, our early and late-onset patient groups were about equal in terms of the severity of their symptoms," according to lead investigator Matthew A. Ciorba, MD, an assistant professor of medicine at Washington University. "However, after a year of treatment, those who had developed colitis later in life had better outcomes. More of them were in clinical remission at one year, compared to those diagnosed when they were younger."

The study involved 295 people treated at the inflammatory bowel disease clinics at the School of Medicine over a seven-year period from 2001-08. After treatment, 64 percent of patients diagnosed after the age of 50 were in remission, compared to 49 percent of those who developed colitis at younger ages. Patients in remission no longer have clinical symptoms of colitis, but many may still have inflammation and may need to continue treatment with 5-ASA drugs, but are able to discontinue steroids.

Ciorba says those diagnosed early in life were more likely to have family members with inflammatory bowel disease and that genetic influences may play a larger role in their disease. More than one in five study patients under age 30 had a family history of inflammatory bowel disease.

"The age at which patients are affected tends to split into two specific waves," Ciorba says. "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."

The researchers suspect that later-onset disease is related to changes in the aging immune system and to environmental influences such as smoking. Nearly 52 percent in the late-onset group were former smo
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Contact: Jim Dryden
jdryden@wustl.edu
314-286-0110
Washington University School of Medicine
Source:Eurekalert  

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