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      The age-related incidence of meconium ileus equivalent in a cystic fibrosis population: the impact of high-energy intake.

      Journal of Pediatric Gastroenterology and Nutrition
      Acetylcysteine, therapeutic use, Adolescent, Adult, Age Factors, Body Height, Body Weight, Child, Child, Preschool, Cystic Fibrosis, complications, diet therapy, Energy Intake, Female, Humans, Infant, Infant, Newborn, Intestinal Obstruction, epidemiology, etiology, Male, Pancreatin

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          Abstract

          During the decade from 1976 to 1986, the age-related incidence of meconium ileus equivalent (MIE) was calculated on the basis of 240 Danish cystic fibrosis (CF) patients. In the first 5 years, the patients were given enteric-coated granules of pancreatic enzymes (Pancreatin, Rosco, Denmark), and a low fat diet was recommended. In the last 5 years, the Center recommended supplementation with acid-resistant, enteric-coated, encapsulated microspheres (Pancrease, Cilag, Birkerød, Denmark), and high-energy intake with a 40% fat content and no dietary restrictions. There was no difference in the incidence of MIE when these two 5-year periods were compared, and the overall incidence of MIE was low (5.4 MIEs/1,000 patient years). This may, at least in part, be due to the rather high intake of exocrine pancreas enzyme supplementation (EPES) (a mean intake of 0.9 capsules/kg/day). MIE occurred almost exclusively among patients greater than 15 years old and peaked in young adults aged 20-25 years (35.5 MIEs/1,000 patient years). The daily intake of EPES/kg of body weight declined significantly with age, and the patients who developed MIE received even less than average per day. Both of these points strengthen the view that a low enzyme dosage is likely to have an effect on the incidence of MIE.

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