JACKSONVILLE, Fla., Month Day, 2025 — For the more than 1.6 million Americans living with inflammatory bowel disease (IBD), staying on top of preventive health is now clearer than ever. A new clinical practice guideline from the American College of Gastroenterology offers updated recommendations on everything from vaccinations to mental health screenings.
This updated guidance focuses on crucial “health maintenance” for IBD patients.
- Adults with IBD aged 50+ should get pneumococcal vaccines.
- Screening for depression and anxiety is recommended annually for all IBD patients.
- Annual skin and cervical cancer surveillance is advised for certain patient groups.
- Bone density testing is suggested at diagnosis and periodically thereafter.
“Patients with IBD often consider their gastroenterologist to be the primary provider of care,” stated the writing group, led by Francis Farraye, MD, director of the Inflammatory Bowel Disease Center at Mayo Clinic, Jacksonville, Florida. “Because more than 70% of patients with IBD will at some time be on medications that will affect the immune system, it is essential that the gastroenterology team promote vaccinations and other health maintenance activities.”
The 27-page guideline, published earlier this month in The American Journal of Gastroenterology, replaces the 2017 recommendations. It provides 12 statements and 11 key concepts, covering vital areas for patients managing chronic conditions.
Prioritizing Vaccinations is Key
Patients with IBD face a higher risk of infections, a risk that can be amplified by immune-modifying therapies. To combat this, the guideline strongly recommends pneumococcal vaccines for adults with IBD aged 50 and older who haven’t received them. A conditional recommendation extends this to adults aged 19-49 on immune-modifying therapy.
Vaccination against herpes zoster, or shingles, is advised for those 50 and older, and for younger patients starting or on immune-modifying treatments. Annual influenza vaccines are a must for all adults with IBD. Those on immune-modifying therapies and their household contacts should opt for the non-live flu vaccine.
Vaccination against respiratory syncytial virus (RSV) is recommended for individuals aged 75 and older, and for those aged 50-74 with certain chronic conditions. The guideline also reinforces the importance of keeping up with vaccinations for tetanus, diphtheria, and pertussis (Tdap), hepatitis A, human papillomavirus (HPV), and meningococcus, as well as hepatitis B for those without immunity.
Cancer Surveillance and Bone Health
The updated guidelines also stress the importance of identifying IBD patients at increased risk for certain cancers. For women with IBD on immune-modifying therapies, annual cervical cancer screening is conditionally recommended. Annual screening for melanoma and nonmelanoma skin cancer (NMSC), particularly for those 50 and older, is also suggested.
Patients with IBD are at an elevated risk for bone loss, potentially leading to osteopenia and osteoporosis. The guideline conditionally recommends screening for osteoporosis with bone mineral density testing at the time of diagnosis and periodically thereafter.
Addressing Mental Health Needs
The guideline acknowledges the higher prevalence of mood disorders, such as depression and anxiety, in patients with IBD compared to the general population. Consequently, it recommends that all patients with IBD be screened for depression and anxiety at baseline and annually. Those who screen positive should be referred for counseling or therapy.
The panel also noted that referrals to dermatology, endocrinology, gynecology, primary care, and psychiatry “may be necessary on a case-by-case basis.” Effective coordination between the gastroenterology team and other healthcare providers is deemed crucial for enhancing the quality of care for individuals living with IBD. This research had no commercial funding.
