This article discusses the symptoms, causes, and treatment options available for someone with DIOS.
Distal Intestinal Obstruction Syndrome Symptoms
When DIOS develops, a person’s bowel movements become blocked, resulting in various symptoms, including:
Abdominal pain and cramping Stomach ache Bloating Vomiting a green or yellow fluid due to bringing up bile from the stomach A mass that can be felt or touched in the abdomen Inability to pass stools or gas Feelings of fullness Diarrhea
The symptoms that present when someone has DIOS are often mild and can be mistaken for appendicitis.
Causes
In CF, thick mucus builds up within the body and can lead to blockages in organs. The organs that are mainly affected are the lungs, pancreas, and intestines.
When that mucus builds up in the digestive tract, it slows down the digestive process. Stool can end up stuck within the intestines behind the area where the mucus has gathered. Together, the mucus and the stool that cannot make their way through the body properly cause a blockage.
Other research suggests that more factors are at play when DIOS develops, such as a lack of proper digestive enzymes meant to break down food properly. The ability to move stool through the intestines may also be compromised in people with DIOS.
Diagnosis
It is fairly easy to diagnose DIOS in people with CF because they are already known to be at risk for it, and the symptoms are specific to an intestinal blockage.
To diagnose the condition, healthcare providers will take a note of all the symptoms a person is experiencing and perform an X-ray of the abdomen to identify where the mass is located.
Treatment
The main goal of treatment is to rid the intestines of the blockage to restore proper bowel movement. There are several ways this can be done:
Genetic predispositionPancreatic insufficiency (when the pancreas doesn’t create enough of digestive enzymes)
Osmotic laxatives: Osmotic laxatives work to soften the stool by drawing fluid from the body into the large bowel. Stimulant laxatives: Stimulant laxatives increase how quickly stool or food moves through the intestines, improving motility within the intestines. They work by encouraging the muscles of the bowel to contract more frequently. Mucolytics: Mucolytics are designed to break down the overabundance of mucus within the intestines.
Other medications can be used to either increase the pancreatic enzymes that may be lacking in the system to help improve digestion or improve the motility of the digestive tract so that food and stool are passed more effectively.
If none of the aforementioned medications work, surgery may be required. Types of surgery that can be used for DIOS include:
Surgical decompression: This surgery is done by decompressing the blockage so it can move freely through the intestines. Caecostomy: Caecostomy is a type of surgery that involves using the pouch found at the opening of the large intestine to form a bridge that can be opened to help drain the blockage. Right hemicolectomy: This surgery is done by removing the right portion of the colon. Afterward, the small intestine is attached to what is left of the colon. Small bowel resection: In this surgery, part of the small bowel is removed.
Summary
DIOS is a complication of cystic fibrosis that occurs when CF-related mucus builds up in the intestines and blocks stool from passing through properly. When a blockage occurs, symptoms such as vomiting, abdominal pain, and difficulty passing stool can develop.
DIOS can cause larger problems if left untreated, but it can be effectively treated early on through various medical interventions such as laxatives and digestive enzymes. Surgery may be required in rare and more severe cases, but it is typically reserved as a last-resort treatment option.
A Word From Verywell
If you have cystic fibrosis and begin experiencing any signs of DIOS, it’s best to meet with your healthcare provider as soon as you can. DIOS is easily dealt with in the majority of cases. Prompt treatment can remedy the situation and negate the need for more invasive interventions such as surgery.
