OTHER areas OF GASTROINTESTINAL MANAGEMENT
Constipation and gastresophageal reflux (which causes heartburn) are the two most common gastrointestinal conditions noticed in people with DMD. Constipation typically occurs at an older age and after surgery. With increasing survival, other complications are becoming reported, including gastric and intestinal swelling related to air swallowing due to ventilator use.
• Laxatives and other medicines can be useful. It is vital that there is enough fluid intake. increasing fiber may make signs and symptoms worse especially if fluids are not increased.
• Reflux is typically treated with suitable drugs. Acid blockers are normally prescribed to children on steroid therapy or oral bisphosphonates to steer obvious of complications.
• Oral care is an vital area, and even though this was not involved in the published international consensus on the care and management of DMD, TREAT-NMD have created professional recommendations for oral care that are outlined in Box 9.Box 9. Oral care Recommendations
• Boys with DMD should see a dentist with extended encounter and detailed knowledge on the disease, preferably at a centralized or specialist clinic. The dentist’s mission should be to strive for high-quality treatment, oral wellness and wellbeing and to function as a resource for the households and also the boy’s own dentist in his home community. This dentist should be mindful on the specific differences in dental and skeletal development in boys with DMD and collaborate with a nicely informed and experienced orthodontist.
• Oral and dental care is to be based on prophylactic measures with a view to maintaining good oral and dental hygiene.
• Individually adapted assistive devices and specialized aids for oral hygiene are of specific importance when the muscular strength on the boy’s hands, arms and neck begins to decrease.