World Inflammatory Bowel Diseases Day
World Inflammatory Bowel Diseases (IBD) day takes place annually on 19 May to raise awareness for those who suffer with Inflammatory Bowel Disease.
The theme for 2022, organised by the European Federation of Chron’s and Ulcerative Collitis Associations (EFCCA) was ‘IBD has no age’. This promotes the impact IBD has on elderly people and their daily lives. It is estimated that in 10 years’ time, older patients will account for 1/3 of all IBD patients.
The EFCCA have promoted key messages they want to focus on. Firstly, the lack of scientific data, where a small proportion of participants enrolled in IBD clinical trials are over 65. This emphasises knock on effects to provide appropriate therapeutic management for the elderly.
Elderly IBD patients are seen at higher risk of comorbidities and complications. Elderly patients are more likely take a higher volume of medication to treat other conditions. By being more vulnerable to comorbidities, this can make elderly patients vulnerable to complications like immunosuppression.
The EFCCA have raised points that IBD can impact patients in different ways and that treatment need to be more tailored to the individual.
Whilst it is important to highlight the impact IBD has on the elderly, IBD is also prevalent in young people. A solicitor at Irwin Mitchell is representing a Claimant regarding an alleged delay in diagnosis of underactive colitis by their GP, resulting with CD undergoing a stoma.
Case Study
CD saw their GP with a two-week history of slightly loose stools, rectal bleeding and mild pain in the abdomen The GP questioned the possibility of infection or piles and arranged for a stool sample and blood tests if the symptoms did not settle. A stool sample was sent but not reported to the practice until 2 weeks later. This showed abnormal fecal calprotectin. The result was seen by a different GP who recorded this as abnormal. The original GP did not contact CD until 10 days after the result and suggested to repeat the fecal calprotectin.
CD visited A&E and it was noted they had ongoing rectal bleeding. No further action was taken. The GP received a further stool sample and the fecal calprotectin was again abnormal. The GP made the note this would be expected, and the test needed to be repeated in 4 weeks’ time.
CD attended A&E again and presented with a three-month history of blood in stool, 2.5 stone of weight loss and vomiting. They were discharged with suspected infectious gastroenteritis. CD saw his GP again and it was noted that CD was unwell and therefore followed F-calp protocol and questioned IBS.
CD then saw a 3rd GP who considered inflammatory bowel disease. The GP made an urgent referral under 2 week wait suspected colorectal cancer pathway.
However, a 4th GP arranged admission for CD. They had an abdominal CT scan and showed evidence of colitis. CD then underwent a total colectomy.
This shows there are gaps in health care systems in not only identifying IBD in patients, but also being able to tailor treatments, particularly with the elderly, to aid with effective treatment management. It is important that we support IBD awareness day to promote their aims and ensure that people of all ages are provided with the treatment that they require.
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