A new UCSF clinic in San Francisco is dedicated to older adults with inflammatory bowel disease, a growing group with distinct medical needs. The IBD Longevity Clinic specifically serves patients 65 and up, providing a holistic, age-focused approach to care.
Among the patients is 81-year-old Peter Milkie. Every four weeks he visits UCSF Mount Zion’s infusion center for about an hour to receive infliximab, a medication that helps alleviate bloating, abdominal cramps, and other ulcerative colitis symptoms. He usually feels tired the following day—a known side effect—but for him, the current treatment pain is outweighed by the long-term benefit of preventing flare-ups—which he describes as very distressing, often involving weight loss, diarrhea, and fear of eating.
Milkie, who has lived with ulcerative colitis for roughly a decade, is not alone. His experience helped inspire the creation of a clinic designed specifically for older adults with IBD, a condition where the immune system misfires in response to external triggers. The IBD Longevity Clinic brings together gastroenterologists, geriatricians, nutritionists, and pharmacists to address the unique needs of seniors who face this chronic disease.
This marks what is believed to be the nation’s first clinic of its kind, signaling a broader shift in medicine toward recognizing and treating older adults with chronic illnesses like IBD in a more specialized way. Aging can intensify IBD issues or complicate their management, as geriatric problems such as bone and muscle loss, frailty, malnutrition, and polypharmacy (the use of multiple prescription medications) often emerge with age.
For many older IBD patients—whether they have ulcerative colitis or Crohn’s disease—bone fractures are a greater risk due to long-standing disease and the impact of chronic steroid use. Corticosteroids like prednisone, long a mainstay for severe flare-ups, accelerate bone loss, and impaired nutrient absorption from affected small intestine can further contribute to bone weakness.
As UCSF gastroenterologist Dr. Kendall Beck, co-founder of the clinic and Milkie’s physician, notes, caring for these patients requires a collaborative, multi-provider approach. Beyond physical health, older adults with IBD may experience social isolation and related declines in both physical and mental well-being, since the disease can cause frequent bathroom trips and urgency, sometimes leading to self-isolation.
There is a noticeable shift in the epidemiology of IBD as well. While it was historically more common among teenagers and young adults, a so‑called second incidence peak appears between ages 60 and 70. Why this happens remains unclear, but possibilities include changes in immune system behavior as people age.
The surge in older adults with IBD is tied to the aging population and rising diagnoses in later life. A recent study projects that by 2030, over one-third of the global IBD population will be aged 60 or older, underscoring the substantial burden on healthcare systems.
Since opening in July, the clinic has seen about 50 patients. Many had not previously consulted a geriatrician, but now benefit from integrated geriatric care that considers cognition, daily functioning, personal goals for aging, and advance care planning, alongside traditional gastroenterology care. Dr. Anu Madhavan, another co-founder and UCSF geriatrician, describes the goal as offering a broader health perspective to help patients meet aging-related objectives in an era of growing chronic disease and an expanding elderly population.
In short, the IBD Longevity Clinic embodies a forward-looking strategy: recognize the complex, evolving needs of older adults with inflammatory bowel disease and coordinate a comprehensive, patient-centered care plan that covers medical treatment as well as overall well-being and long-term aging goals.
