Key takeaway

  • Ulcerative colitis is most often diagnosed in a person’s 30s, but it can occur at any age.
  • The disease sometimes appears in children younger than 6, which is known as very early onset IBD, or after the age of 60, which is referred to as late-onset IBD.
  • While the exact cause of ulcerative colitis is unknown, it is likely due to a combination of genetic and environmental factors.
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This article looks at the age people generally develop UC and the occurrence of early and late-onset UC.

Inflammatory bowel disease (IBD) has two forms: Ulcerative colitis (UC) and Crohn’s. These conditions cause chronic inflammation of all or part of the gastrointestinal tract.

UC can develop at any age, but doctors diagnose most people in their mid-30s.

A 2023 article notes that there are two distinct peaks of onset for UC. The main onset usually peaks between the ages of 15 and 30, and a second onset develops between the ages of 50 and 70. If UC develops after the age of 60, healthcare professionals may refer to this as late-onset IBD.

Due to the combination of factors, it is possible that it could occur earlier or later in life.

Very early onset

Doctors diagnose most children after the age of 15. Although, in rare cases, children under 6 have also received a diagnosis. When a child receives a diagnosis under the age of 6, healthcare professionals consider this to be very early onset IBD (VEO-IBD).

There are three types of VEO-IBD:

  • VEO-IBD: This affects children under 6 years old.
  • Infantile IBD: This affects children under 2 years old.
  • Neonatal IBD: This affects children under 27 days old.

Generally, VEO-IBD causes more extensive inflammation and follows a more severe course than when diagnosed in adulthood.

Late-onset

Some people receive an IBD diagnosis after the age of 60. Late-onset IBD affects 4 to 8 per 100,000 people per year.

Research from 2022 studied a cohort of 94 people between 2000 and 2019 who received a UC diagnosis after 65. The researchers matched the people with other adults diagnosed with UC between 40 and 64.

The clinical manifestations of the disease demonstrated that abdominal pain was less common in late-onset UC compared to mid-late onset.

The risk of developing UC is between 1.6% to 30% if a person has a first-degree relative with the disease. However, it is not possible to predict who and when a person will be affected, or if at all.

While experts do not understand the exact cause of IBD, it usually occurs as a result of multiple factors:

While genetics is a factor in the development of UC, just having genes associated with IBD does not entirely determine if the disease will occur. A person may be more susceptible based on their genetics, but also dependent on environmental triggers.

Possible triggers may include:

There are still some uncertainties surrounding the treatments according to age at IBD diagnosis.

Treatment for VEO-IBD will focus on keeping the disease under control and helping the child to grow well and feel good.

Treatment can include:

  • medications
  • surgery
  • stem cell transplants, if the condition is genetic

Research from 2020 showed that medical professionals performed surgery more frequently in the older population.

UC can affect a person at any age, but most people receive a UC diagnosis in their 30s. However, there is also the possibility that doctors diagnose individuals before the age of 15 or after the age of 60.

The variation in the onset of the disease causes it to manifest differently across age groups. Children generally have more extensive inflammation and widespread areas affected compared to adults.