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Review
How to manage IBD in the ‘elderly’
  1. Jonathan P Segal1,
  2. Hein Myat Thu Htet2,
  3. Jimmy Limdi3,4,
  4. Bu'Hussain Hayee5
  1. 1Department of Gastroenterology, St Mark's Hospital, Watford, UK
  2. 2Gastroenterology, Barts Health NHS Trust, London, London, UK
  3. 3Section of IBD, Division of Gastroenterology, The Pennine Acute Hospitals NHS Trust, Manchester, UK
  4. 4Department of Gastroenterology, Manchester Academic Health Science Centre, Manchester, UK
  5. 5Department of Gastroenterology, King's College Hospital, London, UK
  1. Correspondence to Dr Jonathan P Segal, St Mark's Hospital, Watford HA1 3UJ, UK; jonathansegal1{at}nhs.net

Abstract

As the incidence of inflammatory bowel disease (IBD) rises and the global population ages, the number of older people living with these conditions will inevitably increase. The challenges posed by comorbid conditions, polypharmacy, the unintended consequences of long-term treatment and the real but often underestimated mismatch between chronological and biological ages underpin management. Significantly, there may be differences in disease characteristics, presentation and management of an older patient with IBD, together with other unique challenges. Importantly, clinical trials often exclude older patients, so treatment decisions are frequently pragmatic, extrapolated from a number of sources of evidence and perhaps primarily dictated by concerns around adverse effects. This review aimed to discuss the epidemiology, clinical features and considerations with management in older patients with IBD.

  • IBD
  • elderly
  • ulcerative colitis
  • crohn's disease
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Footnotes

  • Twitter @jonathansegal85, @IBDdoc

  • Contributors JPS, HMTH, JL and BH have all reviewed the literature and prepared the manuscript. All have helped in writing and have contributed to critical revisions of the manuscript.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent for publication Not required.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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