In recent years both in Poland and Europe there have been observed progressive demographic changes and aging of the population. Polypharmacy can be defined as the simultaneous and regular use of at least five different drugs and is particularly often used in elderly patients due to the multimorbidity. According to some sources, elderly people take between two and nine different medications daily, of which even about 60% are inappropriate. The aim of this paper is to summarize information on polypharmacy in seniors in order to plan it as best as possible and at the same time to avoid potential adverse effects, with particular emphasis on the nervous system. One of the most significant for polypharmacy is the age structure of the society. Poland is one of the European countries where the fastest growth of this ratio is observed. Huge problem seems to be the system of educating doctors, which is not adjusted to the changing demographics of the society. Furthermore, one of the factors contributing to polypharmacy is the excessive consumption of dietary supplements by Poles, especially geriatric patients - almost half of Poles consume them regularly. Polypharmacy can be defined as the simultaneous use of at least five different drugs. It is particularly often used in elderly patients due to the multimorbidity and lack of healthcare access. The advantage of polypharmacotherapy is faster achievement of target values, which may improve the patient-doctor relationship, while the disadvantage is the increased risk of side effects. Polypharmacy is a significant problem in the European elderly, to avoid its negative effects, drugs with high bioavailability, short half-lives and a broad therapeutic spectrum are the best choice.

Background/Objectives: Patient-reported outcomes (PROs) capture important dimensions of inflammatory bowel disease (IBD), including fatigue, questionnaire-defined mood-related symptom burden, pain, sleep disturbance, bowel urgency and impaired health-related quality of life, yet these outcomes are incompletely explained by conventional inflammatory markers. Metabolite-related measures may capture host–microbe co-metabolism relevant to patient-reported burden. Methods: This critical narrative review synthesized adult IBD literature linking metabolite-related measures with patient-reported symptom domains. PubMed/MEDLINE, Embase.com, Scopus and Web of Science Core Collection were searched through 11 June 2026; purposive source selection supported critical narrative synthesis rather than exhaustive enumeration. Results: Our structured search identified only a small number of human studies, mainly in fatigue and questionnaire-defined mood-related symptom burden. Studies included serum, plasma or fecal metabolite measurements, exploratory multi-omics, inferred microbial metabolic functions and interventional pathway testing. Fatigue was associated with serum amino-acid-related changes, plasma lipidomic alterations and fecal untargeted metabolomic and microbiome differences; inferred microbial functional modules were also reported. Mood-related burden was associated with serum and fecal metabolomic changes, bile-acid profiles and microbiota-derived functional signals. Within our search and eligibility criteria, no human studies paired measured metabolites with sleep-, pain- or urgency-specific patient-reported outcome measures (PROMs); evidence for multidimensional clusters was insufficient. Conclusions: We did not identify a metabolite-related signature for the assessment of patient-reported burden that had undergone both analytical and clinical validation; findings support candidate associations and exploratory signatures. Future work requires longitudinal, phenotype-stratified cohorts, validated PROMs, rigorous metabolomics methodology, causal modeling, inflammatory and dietary metadata, multiple-testing control and independent validation for clinical translation.