Inflammatory bowel disease and the elderly: a review

J Crohns Colitis. 2015 Jun;9(6):507-15. doi: 10.1093/ecco-jcc/jjv059. Epub 2015 Apr 13.


Inflammatory bowel disease among the elderly is common, with growing incident and prevalence rates. Compared with younger IBD patients, genetics contribute less to the pathogenesis of older-onset IBD, with dysbiosis and dysregulation of the immune system playing a more significant role. Diagnosis may be difficult in older individuals, as multiple other common diseases can mimic IBD in this population. The clinical manifestations in older-onset IBD are distinct, and patients tend to have less of a disease trajectory. Despite multiple effective medical and surgical treatment strategies for adults with Crohn's disease and ulcerative colitis, efficacy studies typically have excluded older subjects. A rapidly ageing population and increasing rates of Crohn's and ulcerative colitis make the paucity of data in older adults with IBD an increasingly important clinical issue.

Keywords: Elderly; inflammatory bowel disease; older.

Publication types

  • Review

MeSH terms

  • Aged
  • Anti-Bacterial Agents / therapeutic use
  • Anti-Inflammatory Agents, Non-Steroidal / therapeutic use
  • Colorectal Neoplasms / diagnosis*
  • Diagnosis, Differential
  • Humans
  • Immunologic Factors / therapeutic use
  • Inflammatory Bowel Diseases / diagnosis*
  • Inflammatory Bowel Diseases / drug therapy*
  • Inflammatory Bowel Diseases / epidemiology
  • Inflammatory Bowel Diseases / etiology
  • Inflammatory Bowel Diseases / surgery
  • Mesalamine / therapeutic use
  • Middle Aged
  • Population Surveillance*
  • Steroids / therapeutic use
  • Tumor Necrosis Factor-alpha / antagonists & inhibitors
  • Vaccination


  • Anti-Bacterial Agents
  • Anti-Inflammatory Agents, Non-Steroidal
  • Immunologic Factors
  • Steroids
  • Tumor Necrosis Factor-alpha
  • Mesalamine