Fibrosing colonopathy

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Fibrosing colonopathy
Other names Abdominal pain, abdominal swelling, vomiting, constipation [1]
CausesHigh doses of pancreatic enzyme supplements [1]
Risk factors Young age, prior surgery of the intestines, certain medications including corticosteroids and H2 blockers [2]
Frequency>60 cases reported [2]

Fibrosing colonopathy is a disease that arises in people with cystic fibrosis treated with high doses of pancreatic enzyme supplements. [1] [2] Symptoms are non-specific with abdominal pain, abdominal swelling, vomiting, and constipation. [1]

Risk factors include being young, prior surgery of the intestines, and the use of certain medications including corticosteroids and H2 blockers. [2] It may appear similar to distal intestinal obstruction syndrome or inflammatory colitis such as Crohn's disease. [1]

A maximum dose of 10,000 IU of lipase per kilogram per day is recommended for pancreatic enzyme supplementation to prevent this condition. [3] More than 60 cases have been described as of 1999. [2] The disease was suggested to be caused by methacrylic acid copolymer which is used as coating for delayed release of enzymes but there is no reliable evidence for that. [4]

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References

  1. 1 2 3 4 5 Smyth RL (May 1996). "Fibrosing colonopathy in cystic fibrosis". Archives of Disease in Childhood . 74 (5): 464–8. doi:10.1136/adc.74.5.464. PMC   1511547 . PMID   8669970.
  2. 1 2 3 4 5 Lloyd-Still, JD; Beno, DW; Kimura, RM (June 1999). "Cystic fibrosis colonopathy". Current Gastroenterology Reports. 1 (3): 231–7. doi:10.1007/s11894-999-0040-4. PMID   10980955. S2CID   37595322.
  3. Schibli, S; Durie, PR; Tullis, ED (November 2002). "Proper usage of pancreatic enzymes". Current Opinion in Pulmonary Medicine. 8 (6): 542–6. doi:10.1097/00063198-200211000-00010. PMID   12394164.
  4. Borum, M. L.; Ginsberg, A. L. (1999). "Lack of evidence for fibrosing colonopathy by 5-ASA in humans". Digestive Diseases and Sciences. 44 (7): 1494. doi:10.1023/a:1026676407838. PMID   10489937. S2CID   34629882.