Format

Send to

Choose Destination
J Cyst Fibros. 2011 Jun;10 Suppl 2:S24-8. doi: 10.1016/S1569-1993(11)60005-2.

Guidelines for the diagnosis and management of distal intestinal obstruction syndrome in cystic fibrosis patients.

Author information

1
Cystic Fibrosis Center, Fondazione IRCCS Cà Granda, Ospedale Maggiore Policlinica, University of Milan, Milan, Italy. carla.colombo@unimi.it

Abstract

Complete or incomplete intestinal obstruction by viscid faecal material in the terminal ileum and proximal colon - distal intestinal obstruction syndrome (DIOS) - is a common complication in cystic fibrosis. Estimates of prevalence range from 5 to 12 episodes per 1000 patients per year in children, with higher rates reported in adults. DIOS is mainly seen in patients with pancreatic insufficiency, positive history of meconium ileus and previous episodes of DIOS. DIOS is being described with increasing frequency following organ transplantation. Diagnosis is based on suggestive symptoms with a right lower quadrant mass confirmed on X-ray. The main differential is chronic constipation. Treatment consists of rehydration combined with stool softening laxatives or gut lavage with balanced electrolyte solutions. Rapid fluid shifts have been described following osmotic agents. Avoiding dehydration and optimizing pancreatic enzyme dosage may reduce the chance of further episodes. Prophylactic laxative therapy is widely used, but is not evidence-based.

PMID:
21658638
DOI:
10.1016/S1569-1993(11)60005-2
[Indexed for MEDLINE]
Free full text

Supplemental Content

Full text links

Icon for Elsevier Science
Loading ...
Support Center