Kivrakoglu F, Kilic V, Ergin M, Kucuk H, Erdogan C, Yuksel I. Clinical characteristics and treatment patterns of older and younger patients with inflammatory bowel disease. World J Gastroenterol 2026; 32(27): 120681 [DOI: 10.3748/wjg.120681]
Corresponding Author of This Article
Fatih Kivrakoglu, MD, Department of Gastroenterology, Adana City Training and Research Hospital, Dr. Mithat Ozsan Bulvari, Kisla Mah. No. 1, Adana 01230, Türkiye. dr.fkivrakoglu@gmail.com
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
research-article
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA
Share the Article
Kivrakoglu F, Kilic V, Ergin M, Kucuk H, Erdogan C, Yuksel I. Clinical characteristics and treatment patterns of older and younger patients with inflammatory bowel disease. World J Gastroenterol 2026; 32(27): 120681 [DOI: 10.3748/wjg.120681]
World J Gastroenterol. Jul 21, 2026; 32(27): 120681 Published online Jul 21, 2026. doi: 10.3748/wjg.120681
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
Fatih Kivrakoglu, Department of Gastroenterology, Adana City Training and Research Hospital, Adana 01230, Türkiye
Vedat Kilic, Department of Gastroenterology, Balıkesir Atatürk City Hospital, Balıkesir 10100, Türkiye
Mustafa Ergin, Department of Gastroenterology, Aksaray Training and Research Hospital, Aksaray 68200, Türkiye
Harun Kucuk, Department of Gastroenterology, Mardin Training and Research Hospital, Mardin 47060, Türkiye
Cagdas Erdogan, Department of Gastroenterology and Hepatology, University of İstinye, İstanbul 34010, Türkiye
Ilhami Yuksel, Department of Gastroenterology, Faculty of Medicine, Ankara Bilkent City Hospital, Ankara Yildirim Beyazit University, Ankara 06800, Türkiye
Co-corresponding authors: Fatih Kivrakoglu and Ilhami Yuksel.
Author contributions: Kivrakoglu F and Kilic V designed the research study; Kivrakoglu F and Ergin M performed the research; Kilic V and Erdogan C analyzed the data; Kucuk H and Erdogan C reviewed the literature; Ergin M and Yuksel I supervised the study; Kivrakoglu F and Yuksel I wrote the manuscript and they contribute equally to this study as co-corresponding authors; and all authors have read and approve the final manuscript.
Institutional review board statement: This study was approved by the Ethics Committee of Ankara Bilkent City Hospital (Approval No. E2-24-6116).
Informed consent statement: The requirement for written informed consent was waived because of the retrospective design of this study and the use of anonymized patient data.
Conflict-of-interest statement: The authors declare that they have no conflicts of interest related to this study.
STROBE statement: The authors have read the STROBE Statement-checklist of items, and the manuscript was prepared and revised according to the STROBE Statement-checklist of items.
Data sharing statement: The data for this article are available within the article. Additional data can be obtained from the corresponding author upon reasonable request.
Corresponding author: Fatih Kivrakoglu, MD, Department of Gastroenterology, Adana City Training and Research Hospital, Dr. Mithat Ozsan Bulvari, Kisla Mah. No. 1, Adana 01230, Türkiye. dr.fkivrakoglu@gmail.com
Received: March 5, 2026 Revised: March 19, 2026 Accepted: April 10, 2026 Published online: July 21, 2026 Processing time: 131 Days and 13.9 Hours
Abstract
BACKGROUND
Inflammatory bowel disease (IBD), including ulcerative colitis (UC) and Crohn’s disease (CD), presents varying clinical characteristics depending on the age at disease onset. With the aging global population, understanding the differences in the presentation and management of older-onset and younger-onset IBD has become increasingly important for optimizing patient care.
AIM
To evaluate the demographic characteristics of and treatment strategies for older and younger adult patients with IBD.
METHODS
A retrospective cohort analysis was conducted on adult patients diagnosed with IBD between June 1993 and February 2023. Demographic, clinical, and therapeutic data were compared between patients with an older onset (≥ 60 years) and younger onset (18-60 years) of UC and CD.
RESULTS
A total of 1245 patients were included, of whom 56 (4.5%) had older-onset disease and 1189 (95.5%) had younger-onset disease. The median follow-up duration was 11 years. UC was more prevalent in the older-onset group (69.6% vs 48.7%, P = 0.002). Biological therapy was used less frequently in older-onset patients (26.8% vs 49.3%, P = 0.001). No significant differences in the extent of UC, CD location or behavior, or perianal involvement were detected between the groups. Smoking and a family history of IBD were more common among patients with a younger age at onset. Extraintestinal manifestations (EIMs) were less frequent in patients with an older age at onset (32.1% vs 51%, P = 0.006). Baseline disease activity scores were similar between groups. Thiopurine use was higher in younger patients (32.9% vs 16.1%, P = 0.008).
CONCLUSION
IBD patients with an older age at onset exhibit distinct demographic and therapeutic characteristics, particularly a lower frequency of EIMs and decreased utilization of immunosuppressive and biological therapies. This conservative approach likely reflects clinical precautions against treatment-related adverse events in elderly individuals; however, it highlights an urgent clinical need for age-specific guidelines to ensure that these patients receive adequate and safe disease management without compromising long-term outcomes.
Core Tip: This retrospective cohort study highlights significant differences in the clinical presentation and management of patients with older-onset vs younger-onset inflammatory bowel disease. Our findings reveal that elderly patients present with fewer extraintestinal manifestations. Notably, older patients receive far fewer immunosuppressive and biological therapies than younger patients do, reflecting a conservative clinical approach likely driven by age-related safety concerns. These results emphasize the urgent clinical need for age-specific management guidelines to ensure that elderly patients receive adequate and safe therapies without compromising long-term outcomes.
