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Drug-Herb Interactions in the Elderly Patient with IBD: a Growing Concern

  • Intractable Disease in the Elderly: When Conventional Therapy Fails (S Katz, Section Editor)
  • Published:
Current Treatment Options in Gastroenterology Aims and scope Submit manuscript

Opinion statement

Inflammatory bowel disease (IBD), which includes conditions such as Crohn’s disease and ulcerative colitis, is becoming more prevalent with the elderly being the fastest growing group. Parallel to this, there is an increasing interest in the use of complementary and alternative medicine (CAM). Nearly half of patients with IBD have used CAM at one time. The elderly patients, however, are burdened by comorbid conditions, polypharmacy, and altered functional status. With increasing use of complementary and alternative medicine in our elderly patients with IBD, it is vital for the provider to provide counsel on drug-herb potential interactions. CAM includes herbal products, diet, dietary supplements, acupuncture, and prayer. In this paper, we will review common CAM, specifically herbs, that are used in patients with IBD including the herb background, suggested use, evidence in IBD, and most importantly, potential interactions with IBD medications used in elderly patients. Most important evidence-based adverse events and drug-herb interactions are summarized. The herbs discussed include Triticum aestivum (wheat grass), Andrographis paniculata (chiretta), Boswellia serrata, tormentil, bilberry, curcumin (turmeric), Plantago ovata (blond psyllium), Oenothera biennis (evening primrose oil), germinated barley foodstuff, an herbal preparation of myrrh, chamomile and coffee extract, chios mastic gum, wormwood (absinthe, thujone), Cannabis sativa (marijuana, THC), tripterygium wilfordii (thunder god vine), Ulmus rubra (slippery elm bark), trigonella foenugraecum (fenugreek), Dioscorea mexicana (wild yam), Harpagophytum procumbens (devil’s claw), ginger, cinnamon, licorice, and peppermint.

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Authors and Affiliations

  1. Department of Internal Medicine, Albany Medical Center, 47 New Scotland Ave, Albany, NY, 12208, USA

    Haider Rahman MD

  2. Division of Gastroenterology, New York Presbyterian Brooklyn Methodist Hospital Weill Cornell College of Medicine, 506 Sixth Street Suite 312 Buckley Pavilion, Brooklyn, NY, 11215, USA

    Marina Kim DO

  3. New York University School of Medicine, 550 1st Avenue NBV 16 North 30, New York, NY, USA

    Galen Leung MD

  4. Perelman School of Medicine, Division of Gastroenterology, University of Pennsylvania, Penn Presbyterian Medical Center, Philadelphia, PA, 19104, USA

    Jesse A. Green MD, FACG

  5. Division of Gastroenterology, New York University School of Medicine NYC North Shore University – Long Island Jewish Hospital System, Manhasset, NY, USA

    Seymour Katz MD, FACP, MACP

  6. St. Francis Hospital, Roslyn, NY, USA

    Seymour Katz MD, FACP, MACP

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  1. Haider Rahman MD
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  2. Marina Kim DO
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Correspondence to Marina Kim DO.

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Haider Rahman declares that he has no conflict of interest.

Marina Kim declares that she has no conflict of interest.

Galen Leung declares that he has no conflict of interest.

Jesse Green declares that he has no conflict of interest.

Seymour Katz declares that he has no conflict of interest.

Jesse Green owns stock in Bristol-Myers Squibb, Merck, and Procter & Gamble, has received research support from GSK, Nestec, and Lycera, and education support from Pfizer and Takeda.

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This article does not contain any studies with human or animal subjects performed by any of the authors.

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The Editors would like to thank Dr. Gary Falk for taking the time to review this manuscript.

This article is part of the Topical Collection on Intractable Disease in the Elderly: When Conventional Therapy Fails

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Rahman, H., Kim, M., Leung, G. et al. Drug-Herb Interactions in the Elderly Patient with IBD: a Growing Concern. Curr Treat Options Gastro 15, 618–636 (2017). https://doi.org/10.1007/s11938-017-0154-y

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