Surgical Treatment for Ulcerative Colitis in the Elderly

Although the number of elderly patients with ulcerative colitis (UC) is increasing, the definition of elderly UC patients differs depending on the report, and the reference age ranges widely from 40 to 75 years. When reading reports of elderly UC patients, it is necessary to check the reference age. The surgical method should not be decided unconditionally based on age. The disease to be operated on, physical strength, anal sphincter muscle, and defecation function should be taken into consideration when deciding whether to perform anal preservation surgery or permanent colostomy surgery. Old age affects postoperative defecation function. Elderly UC patients have low reserve capacity, many comorbidities, and many postoperative complications. Since the mortality rate of emergency surgery in elderly patients is particularly high, it is important to decide on surgery at an earlier stage than in young patients. In reality, elderly UC patients have few subjective symptoms even if they are in a severe or fulminant condition, and it is difficult to judge the suitability for surgery in elderly UC patients. The life and postoperative QOL of elderly UC patients depend on the surgeon who decides on the operation.