title: High ambient temperature and risk of intestinal obstruction in cystic fibrosis.
abstract: OBJECTIVE
  Distal intestinal obstruction syndrome (DIOS) and constipation in cystic fibrosis (CF) are conditions associated with impaction and/or obstruction by abnormally viscid mucofaecal material within the intestinal lumen. Dehydration has been proposed as a risk factor for DIOS and constipation in CF. The study primarily aimed to determine whether warmer ambient temperature and lower rainfall are risk factors for DIOS and constipation in CF.
  
  
  METHODS
  Hospitalisations for DIOS (incomplete or complete) and/or constipation were retrospectively identified (2000-2012). Genotype, phenotype, temperatures and rainfall data (for the week preceding and season of hospitalisation) were collected.
  
  
  RESULTS
  Twenty-seven DIOS (59.3% incomplete; 40.7% complete) and 44 constipation admissions were identified. All admitted patients were pancreatic insufficient. Meconium ileus was significantly more likely in DIOS than constipation (64.7% vs. 33.3%; P = 0.038) and in complete than incomplete DIOS (100% vs. 57.1%; P = 0.04). The maximum temperature of the week before DIOS admission (mean (standard deviation) = 28.0 (5.8) °C) was significantly higher than the maximum temperature of the season of admission (25.2 (3.4) °C; P = 0.002). Similarly, the maximum temperature of the week before hospitalisation for constipation (mean (standard deviation) = 27.9 (6.3) °C) was significantly warmer compared with the season of admission (24.0 (4.1) °C; P < 0.0001). There were no significant differences between levels of rainfall during the week before hospitalisation and the season of admission for both DIOS and constipation.
  
  
  CONCLUSIONS
  Relatively high ambient temperature may play a role in the pathogenesis of DIOS and constipation in CF.
authors.affiliation: Discipline of Paediatrics, School of Women's and Children's Health, Faculty of Medicine, University of New South Wales, Sydney, New South Wales, Australia.|Department of Gastroenterology, Sydney Children's Hospital Randwick, Randwick, New South Wales, Australia.
authors.forename: Chee Y
authors.identifier: http://orcid.org/0000-0001-7111-0926
authors.initials: CY
authors.lastname: Ooi
authors.affiliation: Discipline of Paediatrics, School of Women's and Children's Health, Faculty of Medicine, University of New South Wales, Sydney, New South Wales, Australia.
authors.forename: Christina
authors.initials: C
authors.lastname: Jeyaruban
authors.affiliation: Discipline of Paediatrics, School of Women's and Children's Health, Faculty of Medicine, University of New South Wales, Sydney, New South Wales, Australia.
authors.forename: Jasmine
authors.initials: J
authors.lastname: Lau
authors.affiliation: Department of Nutrition and Dietetics, Sydney Children's Hospital Randwick, Randwick, New South Wales, Australia.
authors.forename: Tamarah
authors.initials: T
authors.lastname: Katz
authors.affiliation: Adult Cystic Fibrosis Centre, The Prince Charles Hospital, Brisbane, Queensland, Australia.|Department of Nutrition and Dietetics, The Prince Charles Hospital, Brisbane, Queensland, Australia.
authors.forename: Angela
authors.initials: A
authors.lastname: Matson
authors.affiliation: Adult Cystic Fibrosis Centre, The Prince Charles Hospital, Brisbane, Queensland, Australia.|Queensland Children's Medical Research Institute, Brisbane, Queensland, Australia.
authors.forename: Scott C
authors.initials: SC
authors.lastname: Bell
authors.affiliation: Discipline of Paediatrics, School of Women's and Children's Health, Faculty of Medicine, University of New South Wales, Sydney, New South Wales, Australia.|Department of Paediatric Surgery, Sydney Children's Hospital Randwick, Randwick, New South Wales, Australia.
authors.forename: Susan E
authors.initials: SE
authors.lastname: Adams
authors.affiliation: Discipline of Paediatrics, School of Women's and Children's Health, Faculty of Medicine, University of New South Wales, Sydney, New South Wales, Australia.|Department of Gastroenterology, Sydney Children's Hospital Randwick, Randwick, New South Wales, Australia.
authors.forename: Usha
authors.initials: U
authors.lastname: Krishnan
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D003550:Cystic Fibrosis / Q000150:complications* / Q000175:diagnosis; D003681:Dehydration / Q000150:complications* / Q000175:diagnosis; D005260:Female; D005500:Follow-Up Studies; D006760:Hospitalization / Q000706:statistics & numerical data*; D006776:Hospitals, Pediatric; D006358:Hot Temperature / Q000009:adverse effects*; D006801:Humans; D015994:Incidence; D007415:Intestinal Obstruction / Q000453:epidemiology* / Q000209:etiology; D008297:Male; D011793:Queensland; D012189:Retrospective Studies; D012307:Risk Factors; D012621:Seasons; D013577:Syndrome
keywords: child; constipation; cystic fibrosis; dehydration; intestinal obstruction; temperature