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

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

How Crohn’s Disease Can Change as You Get Older — and What That Means for Your Care
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Published on February 23, 2026
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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.

What Is the Evolution of Crohn’s Disease?

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.

Evidence suggests Crohn’s severity has a lot to do with when a person was diagnosed. Some studies say people diagnosed with Crohn’s before age 40 are at higher risk for more severe disease than those diagnosed after age 60.

 Adults who are diagnosed later may be less likely to have “classic” Crohn’s symptoms, such as abdominal pain, diarrhea, and fever, than adults diagnosed earlier, who may experience symptoms such as rectal bleeding.

Not all of the research has matched up, though. Other studies have found that elderly-onset and adult-onset inflammatory bowel disease have similar rates of severity. What’s more, older adults with Crohn’s have also been shown to be at higher risk of surgery and treatment-related complications.

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.

How to Manage Crohn’s as You Age

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.

Poorly controlled Crohn’s can increase your risk of complications that could require hospitalization or surgery, such as abscesses, anal fissures, anemia, bowel obstructions, and fistulas.

 What’s more, it can exacerbate health issues that become more common with age in general, including fatigue, joint pain, poor nutrition, reduced bone density, and a higher infection and cancer risk.

Managing Crohn’s starts with getting on the right treatment. And yet, seniors are less likely to receive advanced therapies, such as biologics and small-molecule drugs, that the American Gastroenterological Association recommends for improving long-term outcomes and reducing the chances of Crohn’s getting worse.



Part of the reason: Some of these medications may come with a higher risk of side effects, such as severe infections, in older adults, and insurance, including Medicare, can limit a person’s treatment choices.

 Plus, newer therapies simply haven’t been well studied in people over 60.

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.

The Takeaway

  • 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.
EDITORIAL SOURCES
Everyday Health follows strict sourcing guidelines to ensure the accuracy of its content, outlined in our editorial policy. We use only trustworthy sources, including peer-reviewed studies, board-certified medical experts, patients with lived experience, and information from top institutions.
Resources
  1. Ministro P et al. Age at Diagnosis Is Determinant for the Outcome of Inflammatory Bowel Disease: Is It a Myth? Clinical and Translational Gastroenterology. February 2021.
  2. Sousa P et al. Management of Inflammatory Bowel Disease in the Elderly: A Review. Digestive and Liver Disease. August 2023.
  3. Crohn’s Disease. Cleveland Clinic. December 4, 2023.
  4. Growing Older With Crohn’s or Colitis. Crohn’s and Colitis UK. February 2025.
  5. New AGA Guideline Streamlines Crohn’s Disease Treatment. American Gastroenterological Association. November 20, 2025.
  6. Bermudez H et al. Managing the Older Adult With Inflammatory Bowel Disease: Is Age Just a Number? Current Opinion in Gastroenterology. July 2023.
  7. Lin WC et al. Crohn’s Disease: Specific Concerns in the Elderly. International Journal of Gerontology. September 2016.
  8. Vieujean S et al. Is It Time to Include Older Adults in Inflammatory Bowel Disease Trials? A Call for Action. The Lancet Healthy Longevity. May 2022.
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    Ira Daniel Breite, MD

    Medical Reviewer
    Castle Connolly Top Doctor

    Ira Daniel Breite, MD, is a board-certified internist and gastroenterologist. He is an associate professor at the Icahn School of Medicine at Mount Sinai, where he also sees patients and helps run an ambulatory surgery center.

    Dr. Breite divides his time between technical procedures, reading about new topics, and helping patients with some of their most intimate problems. He finds the deepest fulfillment in the long-term relationships he develops and is thrilled when a patient with irritable bowel syndrome or inflammatory bowel disease improves on the regimen he worked with them to create.

    Breite went to Albert Einstein College of Medicine for medical school, followed by a residency at NYU and Bellevue Hospital and a gastroenterology fellowship at Memorial Sloan Kettering Cancer Center. Working in city hospitals helped him become resourceful and taught him how to interact with people from different backgrounds.

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    Marygrace Taylor

    Marygrace Taylor

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    Marygrace Taylor is an award-winning freelance health and wellness writer with more than 15 years of experience covering topics including women’s health, nutrition, chronic conditions, and preventive medicine. Her work has appeared in top national outlets like Prevention, Parade, Women’s Health, and O, The Oprah Magazine.

    She's also the coauthor of three books: Eat Clean, Stay Lean: The Diet, Prevention Mediterranean Table, and Allergy-Friendly Food for Families. She lives in Philadelphia.

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