Prevalence and management of gastrointestinal complications in Duchenne muscular dystrophy: A retrospective cohort study.

BACKGROUND

Gastrointestinal complications in Duchenne muscular dystrophy (DMD) have been understudied, particularly in Asian populations. This study aimed to determine the frequency and clinical characteristics of gastrointestinal complications.

METHODS

This single-center, retrospective study reviewed medical records of 459 Asian patients with genetically or biopsy-confirmed DMD, aged 1-48 years, from September 1, 2010, to January 1, 2023.

RESULTS

Constipation was the most common complication, affecting 149 patients (32.5 %), followed by dysphagia in 43 patients (9.4 %). Other conditions included irritable bowel syndrome in 8, gastroesophageal reflux disease in 7, hemorrhoids in 6, acute dilatation of stomach in 4, sigmoid colon volvulus in 2, and pneumatosis cystoides intestinalis in 2. Additionally, 1 case each of appendicitis, esophageal diverticulum, paralytic ileus, aerophagia, anal atresia, malabsorption syndrome, fecal incontinence, inflammatory bowel disease, gastrointestinal bleeding, and rectal prolapse was observed. Treatments for constipation included no intervention in 20 patients (13.4 %), sodium picosulfate hydrate in 62 (41.6 %), magnesium oxide in 59 (39.6 %), and polyethylene glycol 4000 in 20 (13.4 %). Logistic regression analysis showed that body mass index (BMI), age and angiotensin converting enzyme inhibitor use was significantly associated with constipation.

CONCLUSIONS

This study highlighted constipation as the most frequent gastrointestinal complication in DMD and identified several rare but serious complications, offering key insights into real-world clinical practice.