Melissa Benoit

Distal intestinal obstruction syndrome (DIOS)

What is distal intestinal obstruction syndrome?

Distal intestinal obstruction syndrome, also called DIOS, is a problem with the bowel or intestine. Food and mucous may partially block your intestine and cause pain. About 5-10% of people with cystic fibrosis get DIOS.

What are the signs and symptoms of DIOS?

If you have DIOS, you may have stomach aches or pain around the belly button, or lower down. You may have cramps. You may not feel as hungry as you usually do, or you may feel full sooner after eating. If your DIOS is really bad, you may throw up and have a lot of pain. Your stool may be very watery. If this happens, go to the emergency department of the hospital nearest to your home for treatment. This hospital can call your CF doctor/clinic for advice.

What causes DIOS?

DIOS is caused by food or mucus sticking to the intestine. Not taking enough pancreatic enzymes may cause DIOS, but we do not know this for sure. You can still get DIOS when you take your enzymes properly. Some patients with cystic fibrosis get DIOS more often than others.

How will you know if you have DIOS?

There are many different causes for stomach aches or pains around the belly button. Only a doctor can tell you if you have DIOS. The doctor will feel your stomach and the area around it. If the doctor thinks that you may have DIOS, he or she will take an x-ray of your intestines.

Can DIOS be treated?

Yes. If your DIOS is very bad, then you will have to drink 4 to 8 litres of a special liquid called ‘golytely’ over a 4 to 8 hour period. Because golytely is very salty, you may not be able to drink it all. If you cannot drink all the golytely, you can have a tube put through your nose into your stomach. This tube is called a nasogastric, or NG, tube. You will then get the golytely through that tube. Usually you will have this treatment during the day in hospital. If you have had golytely before, you can drink it at home instead of in the hospital. If your intestine is not blocked too badly, you may only need to take some mineral oil or other medications. These are medications that help food move through your intestines. The doctor or nurse in the cystic fibrosis clinic will tell you what the best option is for you.

Can you stop DIOS?

If you have had DIOS before, you likely know what it feels like and when it is starting. Sometimes your doctor will prescribe a medication called PEG 3350 (Brand names: Laxaday, Pegalax, Polylax etc.) that you take daily with fluid that may prevent it from reoccuring. The doctor or nurse in the cystic fibrosis clinic will tell you how much PEG 3350 you should take. You should also drink 6 to 8 glasses of water a day..

What should you do if you think you have DIOS?

If you have a pain in the stomach or the area around it that you think might be DIOS, call your CF clinic immediately.