Lavage treatment of distal intestinal obstruction syndrome in children with cystic fibrosis
Koletzko, S.; Stringer, D.A.; Cleghorn, G.J.; Durie, P.R.
Pediatrics 83(5): 727-733
1989
ISSN/ISBN: 0031-4005 PMID: 2717290 Document Number: 346239
The efficacy, adverse reactions, and longterm effects of intestinal lavage treatment with a balanced electrolyte solution (Golytely) was evaluated in patients with cystic fibrosis and distal intestinal obstruction syndrome. Twenty-two patients with cystic fibrosis (mean age 21.8 years, range 14 to 34 years, 15 boys or men) who sought medical attention because of abdominal pain and a mass in the right iliac fossa received Golytely, 5.6 .+-. 1.9 L (mean .+-. 1 SD), either orally (n = 14) or via nasogastic tube (n = 8) during 5.6 .+-. 2.4 hours. No serious side effects occurred. Serum electrolyte values remained within normal limits. Body weight did not change significantly. Minor adverse reactions included bloating (n = 12), nausea (n = 8), vomiting (n = 1), and chills (n = 3). All but one patient reported impressive relief of symptoms and remained pain free for an average of 3 months (range 1 to 19 months). Symptoms of abdominal pain and radiological signs of fecal impaction assessed before and after lavage both decreased significantly (P < .0001). During follow-up (mean 15.2 months, range 4 to 26 months), 11 patients required a total of 38 (range one to nine) additional doses of Golytely. Seven patients drank the solution at home (21 treatments); only two patients chose a nasogastric tube. In ten patients with symptoms of recurrent distal intestinal obstruction syndrome prior to institution of therapy, duration of hospitalization was significantly reduced by this treatment (5.1 .+-. 7.6 v 2.3 .+-. 6.3 hospital days per annum, P < .02).It is concluded that intestinal lavage is a well-accepted, safe, and effective therapy for distal intestinal obstruction syndrome in patients with cystic fibrosis.