IBD (General)

How does IBD affect older people?

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Inflammatory Bowel Disease (IBD) can affect people of all ages, including those who are older (65+). Understanding how IBD manifests in this age group is crucial for providing effective care and improving their quality of life.

Onset and Diagnosis of IBD in those who are 65+

While IBD often begins in adolescence or early adulthood, a significant number of cases are diagnosed in the older population. The challenge lies in differentiating IBD symptoms from those associated with normal ageing or other gastrointestinal conditions. Older individuals may experience diarrhoea, abdominal pain, weight loss, and fatigue, which are classic symptoms of IBD. However, these symptoms can be mistakenly attributed to age-related changes or other gastrointestinal issues, leading to delayed diagnosis and treatment.

Complications and Comorbidities

IBD in those who are older may present with distinct complications compared to younger individuals. Older adults may be more susceptible to nutritional deficiencies due to malabsorption, exacerbating age-related decline in bone density and muscle mass. Additionally, this age group with IBD face an increased risk of developing complications such as infections and bowel obstructions. The presence of comorbidities, common in the ageing population, further complicates the management of IBD.

Impact on Medication Management

Older individuals often have a higher burden of medication due to the management of multiple conditions. The introduction of IBD medications, including immunosuppressants and biologics, may pose challenges in older patients who may already be on various medications. Careful consideration is needed to balance the benefits of IBD treatment with potential risks, such as susceptibility to infections and drug interactions.

Quality of Life

The symptoms and complications associated with IBD can contribute to a decline in functional status among those who are 65+. Fatigue, pain, and gastrointestinal symptoms may limit mobility and independence, affecting their overall quality of life. The emotional toll of chronic illness can also be significant, potentially leading to anxiety and depression, which is why emotional support for those who are older is important to disease management. 

Nutritional Challenges

Older individuals with IBD may face unique nutritional challenges to those who are younger. Malnutrition and weight loss can be more pronounced in this population, impacting their overall health and recovery. Ageing-related changes in metabolism, along with the gastrointestinal symptoms of IBD, may make specialised nutritional plans and close monitoring to ensure proper nutrient intake more important. 

Treatment Challenges 

Treatment decisions for older patients with IBD should consider the overall health, preferences, and goals of care for this population. In most cases, the focus will be on symptom management, improving quality of life, and minimising treatment-related burdens. Shared decision-making involving patients, their families, and healthcare providers is essential to align the treatment plan with the individual’s values and priorities.

Inflammatory Bowel Disease in those who are older presents a unique set of challenges, requiring a holistic and individualised approach to care. Recognizing the distinct features of IBD in this population, from diagnostic hurdles to treatment complexities, is crucial for healthcare professionals. As the older population continues to grow, understanding and addressing the impact of IBD on this demographic is essential for providing compassionate and effective care that enhances their overall well-being.

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