Older Adults with IBD Often Undertreated

Adults with inflammatory bowel disease (IBD) who are older than 65 are often undertreated, reports Medscape . Christina Ha at the Inflammatory Bowel Disease Center at Cedars-Sinai in Los Angeles said doctors sometimes revert to steroid treatment because it is less costly and out of concern that new TNF inhibitors can cause adverse events in older persons. However, she warned that steroid use beyond three months is potentially inappropriate. "If we have someone on steroids, we should be saying which steroid-sparing strategy will be incorporated into their regimen when we start them on their course of steroids," Ha urged. She added that older adults with IBD are less capable of handling disease activity, have more comorbidities, and are prone to falls — making early management of IBD critical. Ha also cited sarcopenia as prevalent in people with moderate to severe IBD. It is also linked to higher risk of infections, hospitalizations, and post-surgical complications. She suggested physical therapy as an underused resource for older IBD sufferers, noting that Medicare covers up to 80 percent of such treatment if referrals are properly worded. Psychosocial assessment could be beneficial as well, as depression is common in those with chronic IBD, and Medicare Part B covers sessions with licensed psychiatrists and clinical psychologists.