ULCERATIVE COLITIS IN A 58-YEAR-OLD MALE PATIENT. CASE REPORT

Abstract

DOI: https://doi.org/10.46296/gt.v8i16.0299

Abstract

Ulcerative colitis is a chronic inflammatory bowel disease that affects the mucosa of the colon and rectum, with a sustained increase in its incidence and prevalence worldwide. Although it usually occurs in young adults, a second peak in incidence has been reported in middle-aged and elderly patients, in whom the presence of comorbidities and polypharmacy can complicate the diagnostic and therapeutic approach. We present the case of a 58-year-old male patient who presented with chronic bloody diarrhea, colicky abdominal pain, and progressive weight loss. Colonoscopy revealed continuous involvement from the rectum to the descending colon, with histopathological findings consistent with moderate-to-severe left-sided ulcerative colitis. Hospital management was initiated with systemic corticosteroids, high-dose mesalazine, and thromboembolic prophylaxis, with partial clinical response, so early introduction of anti-TNF biologic therapy was decided, achieving clinical and endoscopic remission at follow-up. This case highlights the importance of a high index of suspicion in the presence of persistent digestive symptoms in older adults, the central role of colonoscopy with biopsies in confirming the diagnosis, and the need to apply treat-to-target strategies aimed at mucosal healing and modifying the natural course of the disease.

Keywords: Ulcerative colitis; Inflammatory bowel disease; Clinical case; Older adult; Biologics.