Medical management of inflammatory bowel disease in the elderly: balancing safety and efficacy.

The medical management of inflammatory bowel disease (IBD) in the older patient extends beyond luminal disease activity. Factors such as comorbidity, functional status, polypharmacy, and age-related changes in physical reserve and drug metabolism may affect therapeutic decision making. The older patient with IBD is more susceptible to disease-related complications and also to adverse events with therapy, particularly immunosuppression. Appropriate medication selection along with multidisciplinary care, factoring not only disease activity but also these age-related risk factors, may improve therapeutic outcomes and decrease adverse events to therapy.