Inflammatory bowel disease in the elderly

Roughly 15% of all patients with inflammatory bowel disease (IBD) first develop symptoms after age 65. As the number of elderly in the population continues to grow, clinicians should see a greater number of elderly IBD patients. In general, the presenting features of IBD are similar to those encountered in younger patients, but the broad differential diagnosis of colitis in the elderly can make definitive diagnosis more challenging. Whereas most therapies for IBD have not been studied specifically in the elderly, as a general rule, medical and surgical treatment options are the same irrespective of age. Osteoporosis, a condition generally associated with aging, should be managed aggressively in patients with IBD because many older persons already have a substantial baseline risk for accelerated bone loss.