Patterns of use of pancreatic enzyme supplements in fibrosing colonopathy: implications for pathogenesis

Sixteen pathologically confirmed and 14 suspected cases of a new disease entity, fibrosing colonopathy, have been described in the UK and the US in children with cystic fibrosis since 1991. The patterns of use of pancreatic enzyme supplements in cases were compared with use in controls and in the market, in the 2 years prior to surgery for fibrosing colonopathy or the equivalent date in controls. The disease was only found in children with cystic fibrosis who had received brands of pancreatic enzyme supplement coated with methacrylic acid copolymer, for a period of at least 6 months. The risk was dose-related. No cases could be identified in children who had only received other pancreatic enzyme formulations, irrespective of the strength of the formulation or the dose.