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Anal prolapse
- Question
- Dear expert team,
our daughter has CF and takes Kreon at hear meals! She has frequently an anal prolapse when having bowel movements (we have been told that this would be normal in CF and not serious, if it involutes spontaneously) - which is the case. She is otherwise not taking anything else for digestion! She is always pressing strongly even if the stool is always very mushy and thin.
What can we do according to your opinion...we have soon another appointment in the CF center. - Answer
- Hello,
I interprete your report and the question as follows: your daughter, who suffers from CF, shows in spite of a therapy with Kreon an anal prolapse again and again, that involutes spontaneously. You observe, that your daughter presses strongly when she has bowel movments, even if the stool is mushy to thin. You have heard from your CF physicians, that an anal prolapse, that involutes spontaneously, would not be problematic.
I assume, that your daughter is still very young (younger than 3 years) and that the therapy with Kreon is not given for a long time. An anal prolapse in children occurs in 3 different illnesses: these are a long-lasting obstipation, a long-lasting diarrhea and CF. As CF experts we say, that an anal prolapse in case of CF should not occur anymore after a few weeks of a correct therapy with Kreon. You report, that the stool of your child is mushy to thin. In case of a successful therapy with Kreon, the stool should be normal according to age, that means it should be shaped at least in the second year of life. Therefore, it should be clarified as a first step in collaboration with the CF center and the nutritional expert, if the therapy with Kreon is implemented correctly.
If this would be the case, it has to be clarified if other reasons (celiac disease, malabsorption of sugars etc) are underlying, that lead to uncommon mushy stool, as this is the reason for the recurring anal prolapse. In case the problem should persist, a counselling at a specialst for pediatric gastro-enterology would be advisable.
Yours sincerely,
Dr. H.-G. Posselt - 10.02.2014
