How Crohn’s Disease Can Change as You Get Older — and What That Means for Your Care

Whether you’ve been living with Crohn’s for one year or 10, you may be wondering about the future — how the disease can change over time and what you should know to protect your health down the road.

The fact is, Crohn’s disease can behave differently for different people, regardless of age. Experts used to believe Crohn’s was less intense for older adults, but they’ve since learned that isn’t always the case. “It used to be thought that as someone gets older, because they have fewer immune cells and the cells function less well, inflammatory conditions like Crohn’s disease should be milder at older ages,” says Bharati Kochar, MD, a gastroenterologist at Massachusetts General Hospital in Boston. “But we know now that this is not true.”

What is known: No matter the severity of the Crohn’s,the right treatment plan can help keep complications at bay and you feeling your best, now and in the future.

There’s no universal course for Crohn’s disease. “Some older people with long-standing Crohn’s disease go into remission with advancing age, others continue to require medications to maintain their disease, and yet others develop more aggressive disease,” says Dr. Kochar.

Experts are still learning about these differences. “Some older adults seem to have a more ‘inflammatory’ aging process than other older adults,” says Kochar. And for now, it’s tough to say with certainty how any one person’s Crohn’s could change over time.

Controlling Crohn’s is important for the health of your gastrointestinal tract — and your health as a whole. “It is important to ensure that an older adult with Crohn’s disease also aims for true remission like a younger adult,” says Kochar.

Deciding what’s right for you comes down to preferences, Crohn’s severity, and your overall health. “We have to balance the risk of poorly controlled Crohn’s disease against the low risk of an adverse event with effective modern treatments,” says Kochar. “Understanding a patient’s priorities for their health and quality of life guides treatment decision-making.”

No matter the therapy you choose, it’s important to make healthy lifestyle choices, which not only benefit Crohn’s treatment, but also reduce your risk for age-related concerns. “Preventive measures go a long way,” says Kochar. You should:

• Stay up to date on vaccines, including COVID, flu, pneumococcal, and shingles.
• Eat a diet rich in fruits, vegetables, lean proteins, and whole grains and low in ultraprocessed foods.
• See a registered dietitian who specializes in Crohn’s disease to help you catch and address potential nutrient deficiencies, if necessary.
• Get regular physical activity.
• Prioritize getting enough sleep.

• Crohn’s doesn’t always get milder with age. The disease can improve, stay the same, or become more aggressive over time, regardless of age.
• The age at diagnosis may shape how Crohn’s shows up, but results are mixed. Some research links an earlier diagnosis to more severe disease, while other studies show similar severity across age groups, with higher complication risks in older adults.
• Ongoing, personalized treatment is key at any age. Aiming for true remission with the right therapy and healthy lifestyle habits helps reduce complications and protect overall health.