Current Treatment Options in Gastroenterology

, Volume 15, Issue 4, pp 618–636 | Cite as

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

  • Haider Rahman
  • Marina Kim
  • Galen Leung
  • Jesse A. Green
  • Seymour Katz
Intractable Disease in the Elderly: When Conventional Therapy Fails (S Katz, Section Editor)
Part of the following topical collections:
  1. Topical Collection on Intractable Disease in the Elderly: When Conventional Therapy Fails

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.


Inflammatory bowel disease IBD Aging Elderly Herbal Complementary Alternative CAM Interactions Crohn’s disease Ulcerative colitis Adverse events Drug-herb interactions Wheatgrass Turmeric Barley Chios mastic gum Absinthe Wormwood Cannabis Marijuana THC Primrose Ginger Cinnamon Licorice Peppermint 


Compliance with ethical standards

Conflict of interest

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.

Human and animal rights and informed consent

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

References and Recommended Reading

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Copyright information

© Springer Science+Business Media, LLC 2017

Authors and Affiliations

  • Haider Rahman
    • 1
  • Marina Kim
    • 2
  • Galen Leung
    • 3
  • Jesse A. Green
    • 4
  • Seymour Katz
    • 5
    • 6
  1. 1.Department of Internal MedicineAlbany Medical CenterAlbanyUSA
  2. 2.Division of GastroenterologyNew York Presbyterian Brooklyn Methodist Hospital Weill Cornell College of MedicineBrooklynUSA
  3. 3.New York University School of MedicineNew YorkUSA
  4. 4.Perelman School of Medicine, Division of GastroenterologyUniversity of Pennsylvania, Penn Presbyterian Medical CenterPhiladelphiaUSA
  5. 5.Division of GastroenterologyNew York University School of Medicine NYC North Shore University – Long Island Jewish Hospital SystemManhassetUSA
  6. 6.St. Francis HospitalRoslynUSA

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