Understanding Inflammatory Bowel Disease in the Elderly: Challenges and Treatment Strategies

Inflammatory Bowel Disease (IBD), encompassing ulcerative colitis (UC) and Crohn’s disease (CD), presents a unique clinical challenge, particularly in the elderly population. While the etiopathogenesis and treatment strategies for IBD are largely consistent across age groups, the disease manifests differently in older adults, often with increased susceptibility to infections and a heightened risk of colorectal cancer (CRC). Current guidelines suggest total proctocolectomy for UC patients diagnosed with CRC and total colectomy or proctocolectomy for CD patients, with segmental colectomy as a potential option for select older patients. Despite these guidelines, there remains a significant gap in understanding the interaction of polypharmacy with IBD medications, the impact of systemic and mucosal immune aging, and the role of a dysbiotic microbial ecosystem in the pathophysiology of IBD in the elderly. Furthermore, nutritional deficiencies and the need for specific management guidelines for elderly IBD patients highlight the necessity for more focused research in this area.

This Research Topic aims to consolidate recent findings on the clinical behavior of IBD in the elderly, explore the evolving epidemiology of the disease globally, and examine advancements in diagnostic methodologies and age-related treatment strategies. It seeks to address the pressing issue of colorectal cancer and precancerous conditions in this demographic, providing insights into the daily challenges faced by older adults with IBD. By gathering comprehensive data, the research aims to enhance understanding and improve outcomes for elderly IBD patients.

To gather further insights into the complexities of IBD in the elderly, we welcome articles addressing, but not limited to, the following themes:
- Epidemiological aspects of IBD in the elderly
- Polypharmacy in the elderly: prevalence, impact, pharmacological interactions
- Immunological responses in the elderly: implications for disease pathophysiology
- Risk of chronic diseases in older adults with IBD
- Infections (viral, microbial, TBC, etc.) in older adults with IBD
- Indications and safety of newer IBD treatments
- Biologic and micromolecular agents: safety and treatment results
- Nutritional support in elderly patients with IBD
- Surgical treatment of IBD in older adults
- Post-surgical complications
- CRC in elderly patients with IBD
- Surveillance for malignancy in elderly patients with IBD

We invite original papers, systematic reviews, meta-analyses, case descriptions, and therapeutic trials to contribute to this vital area of research.