Distal Intestinal Obstruction Syndrome in adults
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What is DIOS?
DIOS is a common complication of cystic fibrosis that is characterized by a complete or incomplete obstruction within the bowel / intestine.
What causes DIOS?
DIOS is caused by the accumulation of fecal material and sticky intestinal contents which adhere to the lining of the intestinal wall and cause impactions / obstructions. This is not CONSTIPATION. Some studies suggest that not taking adequate enzymes or as prescribed may contribute to DIOS. Not drinking adequate fluid and being dehydrated may also contribute to DIOS.
What are the signs and symptoms of DIOS?
You may have stomach pain (usually quite painful and on the right side of your abdomen), abdominal bloating / distension, backache, and sometimes nausea /vomiting. At the same time you may experience a change in bowel movements which can include watery stools. Appetite and oral intake may be decreased.
Can DIOS be treated?
Yes it can be treated and this will be individualized to the severity of your DIOS. This may include laxatives and/or an enema to clean out your bowels/intestine.
Can DIOS be prevented?
Having had DIOS once makes you at risk for having another episode and your clinic team may prescribe a preventative laxative therapy. It is important for all to have a healthy diet, adherence to adequate enzyme dosage and drink 8-10 glasses water/day to prevent dehydration. Daily exercise is also recommended as this helps to move stool through the bowel / intestine.
What to do if you think you have DIOS
If you have any of the signs and symptoms of DIOS it is important that you contact your CF team / clinic immediately. You will need to come into clinic to be examined and if necessary an X-ray to either rule out or confirm that you have DIOS. If you do have DIOS then a treatment plan will be established for you. You may or may not be admitted to hospital depending on the severity of the DIOS and treatment required.
It is very important that if you go to the emergency department that your cystic fibrosis team is notified immediately and made aware of your symptoms as DIOS may not be diagnosed.