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History of perianal fistulizing lesions in patients with elderly-onset Crohn's disease: a population-based study.

Lady Organic

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Natural history of perianal fistulizing lesions in patients with elderly-onset Crohn's disease: a population-based study.

These results are concerning for old age. Only a minority of elderly patients with perianal-fistulizing seem to be treated with an anti-TNF agent:
''Although 37% of the patients received immunosuppressants and 17% received anti-tumour necrosis factor agents, 24% had a definitive stoma at last follow-up. ''
This gives me, AGAIN, the impression that older people may receive sub-optimal treament in institutions, a form of discrimination to me, based on the age of the patient. Exploration of all options including known most beneficial treatment for fistulizing CD before definitive surgery seems to be skipped in this population.
The authors conclude at least with a positive direction: ''Our results suggest that treatment with biologics should be evaluated in these patients.''
 
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