A case of ulcerative colitis in old age with chronic pulmonary emphysema

Abstract

A 78-year-old man treated by oxygen therapy and low-dose prednisolone (5mg/day) for chronic pulmonary emphysema contracted pneumonia and was prescribed antibiotics by his home doctor. About a week later, he was admitted to our medical center because of severe hematochezia. The disease was diagnosed as the total colitis type of ulcerative colitis based on colonoscopic findings. After his pneumonia improved, the patient was started on prednisolone 40mg/day, corticosteroid enema, and total parenteral nutrition. 6 weeks later the patient's condition improved.
Ulcerative colitis in older patients aged over 70 has been considered more severe than that in younger persons, but our patient responded well to medical therapy and has not relapsed for eighteen months.
Smoking is the most common cause of chronic pulmonary emphysema. Current smokers are at a decreased risk of developing ulcerative colitis, while former smokers face an increased risk. We suspect that smoking and low-dose prednisolone protected our patient form ulcerative colitis until he reached the advanced age of 78 year-old.