Ultrasonography of bowel in the right lower quadrant in patients with cystic fibrosis. Correlation with pancreatic enzyme replacement and clinical symptoms

Purpose:In some reports a correlation has been described between the use of excessive pancreatic enzyme supplements (up to 100 000 E Lipase/kg/d) and fibrosing colonopathy. The aim of this study was to determine the prevalenc e of sonographic bower wall thickening in CF patients and its correlation w ith pancreatic enzyme replacement and clinical symptoms. Methods:ln 51 CF patients, bowel wall thickness of the terminal ileum/colon ascendens and presentation of the appendix were evaluated by ultrasonograp hy. Thickening of the bowel wall was defined as a wall diameter >2 mm. Results:17,6% patients showed a thickened bowel wall (>2 mm) of the termina l ileum, 35,3% a colonic thickening. Patients on a sta nda rd strength panc reatic preparation (up to 6000 E lipase/kg/d) showed more often bowel wall thickening than patients with enzyme replacement between 6000-15 000 E/kg/d . There was a negative correlation between bowel wall thickness and relativ e dosage of pancreatic enzymes (p<0,05). Conclusion:ln patients on a pancreatic preparation dosed up to 15 000 E Lip ase/kg/d there was no positive correlation betweeen enzyme replacement/dosa ge and bowel wall thickness.