Other areas of gastrointestinal management
Constipation and gastroesophageal reflux (which causes heartburn) are the two most common gastrointestinal conditions seen in individuals with DMD. Constipation typically occurs at an older age and after surgery. With increasing survival, other complications are being reported, including gastric and intestinal swelling related to air swallowing due to ventilator use.
- Laxatives and other medicines can be useful. It is important that there is enough fluid intake. Increasing fibre may make symptoms worse especially if fluids are not increased.
- Reflux is typically treated with appropriate drugs. Acid blockers are commonly prescribed to children on steroid therapy or oral bisphosphonates to avoid complications.
- Oral care is an important area, and although this was not included in the published International consensus on the care and management of DMD, TREAT-NMD have developed expert recommendations for oral care that are outlined here.