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Intestinal problems with CF
- Question
- What are options and experiences regarding examination and diagnostics in case of repeated abdominal colics and assumed constipation, intestinal stenosis up to the point of quasi-obstruction of the bowels in individuals with CF?
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Wouldn’t it make sense for adult CF patients to have a colonoscopy on a regular basis?
Thank you for your advice.
Kind regards - Answer
- Hello,
you are reporting frequent constipation up to the point of a possible obstruction of the bowels and are asking which diagnostics would be sensible.
The reasons for the problems you are describing can be manifold. Some CF patients had a so-called Meconium ileus as a child. In this case, the surgery necessary at newborn age can cause transportation problems in the intestines. Here, an X-ray of the intestines would make sense.
Occasional stool retention, on the other hand, occurs much more frequently in individuals with CF. During a physical examination, finds an accumulation of stool in the transitional area between small and large intestine can often be found. This phenomenon is called “distal intestinal obstruction syndrome.” It can have many different causes but is mostly triggered by an uneven dosage of pancreatic enzymes (too much is equally bad as too little). Another cause could be insufficient liquid intake. To clarify this question, an ultrasound exam of the intestines will be helpful in addition to a thorough physical exam. To treat the problem, colonic irrigations (both orally and via the large intestine) are necessary. Orally, significant quantities of macrogol solutions are given; rectally, a mixture of sodium chloride and acetylcysteine is used for rinsing. For the future, a prophylactic enzyme therapy and concurrent plentiful fluid intake is advisable.
Rarely, intestinal obstruction can be caused by an inflammation of the bowels. To clarify this, adequate blood tests and, if necessary, a colonoscopy will make sense. Regular colonoscopies, on the other hand, do not seem reasonable with CF.
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Kind regards
Dr. H.-G. Posselt - 23.06.2010
