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Re: Ulcerative colitis

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My son (2.5yr old) was also diagnosed with UC about a year ago after

he has a lot of vomiting and some blood in his stool. They did a

colonoscopy and said it was UC. I didn't believe it. He was put on

sulfasalazine and we didn't see any more blood. I NEVER believed he

had UC--he had no other symptoms. When we moved to Kansas, we saw a

new GI dr and he also agreed with me. The GI doc and I believed that

the enzymes were just irritating his colon. We stopped the

medication and haven't had any problems with it since.

On a side note, I would be very cautious about using Barium. It is

counterindicative in kids with CF. It caused a severe blockage in my

son--so bad it nearly required surgery. They can use something

called Gastro Graffin that works fine.

Jennfer

> My six year old girl with CF was born with meconium illeus. She has

been in the hospital with sever abdominal pain. To make a long story

short, she was passing small amounts of blood in her stools, X-ray's

showed a large amount of gas build up in the large intestine and

stool in the small intestine. they performed a barium enema and that

cleaned her out. she felt better after that but after she ate she

started hurting again. She had loose stools but not runny stools. The

x-ray's showed no blockages or adhesions from earlier surgery. after

a week in the hospital she has been sent home. They are now telling

me she could have Ulcerative colitis but does not want to do a

colonoscopy until she is feeling better and not hurting. My Question

is, How is this related to CF? has anyone out there had this and what

is your experience with this?

> Tracey Oldham

> toldham@l...

>

>

>

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Hi Tracey,

I am not aware of a connection between CF and ulcerative colitis. But

there is a similar complication called fibrosing colonopathy, that is

found more often in pwcf. When you google for CF and fibrosing

colonopathy you'll get some hits. Ask your docs whether they know

about this.

The other real risk is, that due to the prolonged use of antibiotics

pwcf are prone to infections with clostridium difficile, a nasty bug

that can cause colitis too.

Peace

Torsten

Fibrosing colonopathy revealing cystic fibrosis in a neonate before

any pancreatic enzyme supplementation.

Serban DE, cu P, Miu N.

Pediatric Clinic II, University of Medicine and pharmacy, Cluj-

Napoca, Romania. danielaserban@...

Although its pathogenesis remains still unknown, fibrosing

colonopathy (FCP) is considered to be the result of prolonged

treatment by high doses of pancreatic enzyme preparations, in a small

proportion of patients who present with cystic fibrosis (CF). We

present the case of a newborn with meconium ileus (treated by

conservative measures), in which, at the age of 3 weeks, the features

of intestinal obstruction made necessary the removal of 15 cm of the

proximal large intestine. Macroscopical and especially microscopical

appearances typical for FCP were found, despite the absence of any

enzymatic treatment. These findings raised the suspicion of CF, which

was confirmed 4 weeks later at necropsy by the presence of

characteristic pancreatic lesions. This case and another similar

report in the literature suggest that the mechanism of FCP must be

linked with the disease itself, at least in some patients. Thus, for

us, FCP is not a " closed subject " and we sustain the importance of

continuing studies, which will shed light on its etiopathogenesis.

****************************************************************

Can J Gastroenterol. 2001 Sep;15(9):586-90.

Colonic disorders in adult cystic fibrosis.

Chaun H.

St 's Hospital and University of British Columbia, 805 West

Broadway, Vancouver, British Columbia V5Z 1K1, Canada.

hchaun@...

By 1996, the median survival of patients with cystic fibrosis (CF) in

North America had increased to 31 years. With the markedly improved

life expectancy, many CF patients are now adults. There is an

associated increased risk of certain colonic disorders, and the

emergence of other previously unrecognized disorders, in adult CF

patients. The distal intestinal obstruction syndrome (DIOS), which is

more common in older patients, is a frequent cause of abdominal pain.

Intussusception may complicate DIOS; other differential diagnoses

include appendiceal disease, volvolus, Crohn's disease, fibrosing

colonopathy and colonic carcinoma. The diagnosis of acute

appendicitis, although uncommon in patients with CF, is often

delayed, and appendiceal abscess is a frequent complication. The

prevalence of Crohn's disease in CF has been shown to be 17 times

that of the general population. Right-sided microscopic colitis is a

recently recognized entity in CF of uncertain clinical significance.

Fibrosing colonopathy has been confined mostly to children with CF,

attributed to the use of high strength pancreatic enzyme supplements,

but it has been reported in three adults. Nine cases of carcinoma of

the large intestine have been reported worldwide, associated with an

apparent excess risk of digestive tract cancers in CF. Despite high

carrier rates of Clostridium difficile in patients with CF,

pseudomembranous colitis is distinctly rare, but severe cases

complicated by toxic megacolon have been reported. In these patients,

watery diarrhea is often absent. Adult CF patients with refractory or

unexplained intestinal symptoms merit thorough investigations.

Publication Types:

Review

Review, Tutorial

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