Document Detail


Relation of thickening of colon wall to pancreatic-enzyme treatment in cystic fibrosis.
MedLine Citation:
PMID:  7534369     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Fibrotic strictures of the colon in association with colon-wall thickening on abdominal ultrasound have been described in children with cystic fibrosis. We determined the prevalence of colon-wall thickening in 99 children with cystic fibrosis (aged 6 months to 17 years, 45 male) and 38 healthy controls (aged 1 month to 39 years, 21 male). In controls, peristalsis was uniformly rapid and maximum wall thickness of the fully relaxed colon was 0.8 mm (median 0.6 mm). 24% of the patients had a colon-wall thickness of 1.5 mm or more (maximum 3.4 mm); 48% of children on high-strength pancreatin receiving more than 265 units/kg per day of protease had thickening of more than 1.5 mm compared with less than 12% of children on any other dose. Children on high-strength pancreatin were 5.2 (95% CI 1.2-21) times more likely to have colon-wall thickness of 1.5 mm or more than children taking less than 265 units/kg per day of protease in a standard-strength preparation. This risk rose to 10 (2.5-39) times more likely if laxatives were taken with a high-strength preparation. Lipase or amylase intake, age, sex, genotype, and other medical or drug history were not significantly associated with colon-wall thickening. 1 child required a hemicolectomy for bowel obstruction and another developed haemorrhagic colitis. In 17 children, 2 months after stopping high-strength, high protease, preparations and efforts to reduce enzyme intake, colon-wall thickness had regressed from a median 2.0 mm (range 1.0-3.4) to 1.8 mm (0.9-2.7) (p = 0.005). The use of high-strength pancreatin preparations in conjunction with a high protease intake probably causes thickening of the wall of the colon.
Authors:
E J Mac Sweeney; P J Oades; R Buchdahl; M Rosenthal; A Bush
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Lancet     Volume:  345     ISSN:  0140-6736     ISO Abbreviation:  Lancet     Publication Date:  1995 Mar 
Date Detail:
Created Date:  1995-04-14     Completed Date:  1995-04-14     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  2985213R     Medline TA:  Lancet     Country:  ENGLAND    
Other Details:
Languages:  eng     Pagination:  752-6     Citation Subset:  AIM; IM    
Affiliation:
Department of Paediatric Respiratory Medicine, Royal Brompton Hospital, London, UK.
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Amylases / administration & dosage,  therapeutic use*
Child
Child, Preschool
Colon / drug effects,  pathology*,  ultrasonography
Cystic Fibrosis / drug therapy*,  pathology,  ultrasonography
Endopeptidases / administration & dosage,  therapeutic use*
Fibrosis
Humans
Infant
Infant, Newborn
Lipase / administration & dosage,  therapeutic use*
Logistic Models
Male
Retrospective Studies
Chemical
Reg. No./Substance:
EC 3.1.1.3/Lipase; EC 3.2.1.-/Amylases; EC 3.4.-/Endopeptidases

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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