Intestinal Research

IBD

Elderly-onset inflammatory bowel disease in Asia: clinical characteristics and therapeutic strategies: Jiyoung Yoon, Daein Kim, You Sun Kim; Intest Res 2025;23(4):430-442. Published online October 28, 2025; DOI: https://doi.org/10.5217/ir.2025.00221

The incidence and prevalence of elderly-onset inflammatory bowel disease (EO-IBD) are increasing worldwide. The rising incidence of EO-IBD in Asia is driven by rapid industrialization and an aging population. Older patients often have multiple comorbidities and polypharmacy, which make diagnosis and management of the disease more challenging. Additionally, Asian patients with EO-IBD exhibit unique clinical characteristics, including frequent ileal involvement. Differences in phenotype between patients with EO-IBD in Western and Asian countries may explain subsequent disparities in the natural history of these patients. Although EO-IBD often manifests with a mild clinical course at diagnosis, it poses distinct diagnostic and therapeutic challenges. Understanding these characteristics is essential for optimizing patient care and for optimizing patient outcomes. In this review, we explore the epidemiology, disease burden, and clinical characteristics of EO-IBD in Asia, as well as the therapeutic approaches for treating the disease.

Citations

Citations to this article as recorded by

A Review of the Use of Mobile Health Interventions in Patients with Inflammatory Bowel Disease
Qun Zhang, Jiangwei Zhou, Weishang Lei, Shiyun Tong
Journal of Multidisciplinary Healthcare.2026; Volume 19: 1. CrossRef
Tofacitinib in older patients with ulcerative colitis: balancing efficacy and safety
Yoon Suk Jung
Intestinal Research.2026; 24(2): 193. CrossRef

4,241 View
67 Download
2 Web of Science
2 Crossref

Endoscopy

Balancing safety and effectiveness in colonoscopy for older adults: a narrative review: Min-Jae Kim, Yuna Kim, Jie-Hyun Kim, Young Hoon Youn, Jaeyoung Chun; Intest Res 2025;23(4):443-454. Published online October 2, 2025; DOI: https://doi.org/10.5217/ir.2025.00092

Abstract PDF PubReader ePub

Colonoscopy is becoming more widely used in older adults for screening and diagnostic evaluation of colorectal cancer. While advanced age itself is not a contraindication, elderly patients often present unique challenges, including frailty, comorbidities and polypharmacy, which increase the risk of complications during the procedure. Rather than chronological age alone, frailty is important in risk assessment and clinical decision-making before performing a colonoscopy. This review summarizes recent evidence, particularly from large cohort studies and clinical guidelines, to provide a balanced evaluation of the advantages and disadvantages of performing colonoscopies on older adults. Ultimately, we emphasize the importance of judicious patient selection, customized bowel preparation and tailored sedation management to optimize the safety and effectiveness of colonoscopy in this vulnerable group.

Citations

Citations to this article as recorded by

Achievements and Future Directions of the National Colorectal Cancer Screening Program in Korea
Tae-Woo Kim, Soo-Young Na
The Korean Journal of Gastroenterology.2026; 86(2): 104. CrossRef
Liquid biopsy for colorectal cancer screening: chances and challenges
Hyoung Il Choi, Jae Myung Cha
Intestinal Research.2026;[Epub] CrossRef

7,098 View
139 Download
2 Web of Science
2 Crossref

IBD

Clinical spectrum of elderly-onset inflammatory bowel disease in India: Yogesh Kumar Gupta, Arshdeep Singh, Vikram Narang, Vandana Midha, Ramit Mahajan, Varun Mehta, Dharmatma Singh, Namita Bansal, Madeline Vithya Barnaba Durairaj, Amit Kumar Dutta, Ajit Sood; Intest Res 2023;21(2):216-225. Published online August 8, 2022; DOI: https://doi.org/10.5217/ir.2021.00177

Abstract PDF PubReader ePub

Background/Aims
Inflammatory bowel disease (IBD) is increasingly being recognized in elderly patients. Data on clinical spectrum of elderly-onset IBD patients is lacking from India.
Methods
A cross-sectional retrospective analysis of a prospectively maintained database of patients diagnosed with IBD was conducted at 2 centers in India. The clinical spectrum of elderly-onset IBD including demographic profile (age and sex), clinical presentation, disease characteristics (disease behavior and severity, extent of disease), and treatment were recorded and compared with adult-onset IBD.
Results
During the study period, 3,922 (3,172 ulcerative colitis [UC] and 750 Crohn’s disease [CD]) patients with IBD were recorded in the database. A total of 186 patients (4.74%; 116 males [62.36%]) had elderly-onset IBD (69.35% UC and 30.64% CD). Diarrhea, blood in stools, nocturnal frequency and pain abdomen were the commonest presentations for UC, whereas pain abdomen, weight loss and diarrhea were the most frequent symptoms in CD. For both elderly onset UC and CD, majority of the patients had moderately severe disease. Left-sided colitis was the commonest disease location in UC. Isolated ileal disease and inflammatory behavior were the most common disease location and behavior, respectively in CD. 5-Aminosalicylates were the commonest prescribed drug for both elderly onset UC and CD. Thiopurines and biologics were used infrequently. Prevalence of colorectal cancer was higher in elderly onset IBD.
Conclusions
Elderly onset IBD is not uncommon in India. Both the elderly onset UC and CD were milder, with no significant differences in disease characteristics (disease extent, location and behavior) when compared to adult-onset IBD. Colorectal cancer was more common in elderly onset IBD.

Citations

Citations to this article as recorded by

Current approaches to managing inflammatory bowel disease in the elderly – A literature review
Maciej Zamorski, Agata Stebel, Alicja Gładysz
Annales Academiae Medicae Silesiensis.2026; 80: 155. CrossRef
Clinical characteristics and treatment patterns of older and younger patients with inflammatory bowel disease
Fatih Kivrakoglu, Vedat Kilic, Mustafa Ergin, Harun Kucuk, Cagdas Erdogan, Ilhami Yuksel
World Journal of Gastroenterology.2026;[Epub] CrossRef
Inflammatory bowel disease in south Asia: a scoping review
Shabari Shenoy, Anuraag Jena, Carrie Levinson, Vishal Sharma, Parakkal Deepak, Tina Aswani-Omprakash, Shaji Sebastian, Jean-Frederic Colombel, Manasi Agrawal
The Lancet Gastroenterology & Hepatology.2025; 10(3): 259. CrossRef
Metabolic Disorders and Inflammatory Bowel Diseases
Hye Kyung Hyun, Jae Hee Cheon
Gut and Liver.2025; 19(3): 307. CrossRef
Elderly-onset inflammatory bowel disease in Asia: clinical characteristics and therapeutic strategies
Jiyoung Yoon, Daein Kim, You Sun Kim
Intestinal Research.2025; 23(4): 430. CrossRef
Inflammatory Bowel Disease in the Elderly
Rachid El Jim, Chaimae Maroute, Asmae Lamine, Maria Lahlali, Hakima Abid, Nada Lahmidani, Amine El Mekkaoui, Mounia El Yousfi, Dafr-Allah Benajah, Sidi Adil Ibrahimi, Mohammed El Abkari
Open Journal of Gastroenterology.2025; 15(07): 376. CrossRef
Impact of age at diagnosis on long‐term prognosis in patients with intestinal Behçet's disease
Ji Young Chang, Soo Jung Park, Jae Jun Park, Tae Il Kim, Jae Hee Cheon, Jihye Park
Journal of Gastroenterology and Hepatology.2024; 39(3): 519. CrossRef
Neither hepatic steatosis nor fibrosis is associated with clinical outcomes in patients with intestinal Behçet’s disease
Hye Kyung Hyun, Jihye Park, Soo Jung Park, Jae Jun Park, Tae Il Kim, Jae Seung Lee, Hye Won Lee, Beom Kyung Kim, Jun Yong Park, Do Young Kim, Sang Hoon Ahn, Seung Up Kim, Jae Hee Cheon
European Journal of Gastroenterology & Hepatology.2024; 36(4): 445. CrossRef
Inflammatory bowel disease: a narrative review of disease evolution in South Asia and India over the last decade
Sahana Shankar, Snehali Majumder, Suparna Mukherjee, Anirban Bhaduri, Rangarajan Kasturi, Subrata Ghosh, Marietta Iacucci, Uday N. Shivaji
Therapeutic Advances in Gastroenterology.2024;[Epub] CrossRef
A prospective study of inflammatory bowel disease phenotypes in extremes of age and comparison with adults
Nikhil Bhangale, Devendra Desai, Philip Abraham, Tarun Gupta, Pavan Dhoble, Anand Joshi
Indian Journal of Gastroenterology.2023; 42(3): 404. CrossRef
Global Epidemiology and Burden of Elderly-Onset Inflammatory Bowel Disease: A Decade in Review
Pojsakorn Danpanichkul, Kanokphong Suparan, Suchapa Arayakarnkul, Aunchalee Jaroenlapnopparat, Natchaya Polpichai, Panisara Fangsaard, Siwanart Kongarin, Karan Srisurapanont, Banthoon Sukphutanan, Wasuwit Wanchaitanawong, Yatawee Kanjanakot, Jakrapun Pupa
Journal of Clinical Medicine.2023; 12(15): 5142. CrossRef

9,335 View
537 Download
9 Web of Science
11 Crossref

Search