Article Text

Download PDFPDF
Emergency colonoscopy for distal intestinal obstruction syndrome in cystic fibrosis patients
  1. R G Shidrawi1,
  2. N Murugan1,
  3. D Westaby1,
  4. K Gyi2,
  5. M E Hodson2
  1. 1Department of Gastroenterology, Chelsea and Westminster Hospital, 369 Fulham Rd, London SW10 9NH, UK
  2. 2Cystic Fibrosis Unit, Royal Brompton Hospital, Sydney Street, London SW3, UK
  1. Correspondence to:
    Dr R G Shidrawi, Academic Department of Medical and Surgical Gastroenterology, Homerton Hospital, Homerton Row, London E9 6SR, UK;

Statistics from

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.

Recent advances in the treatment of cardiorespiratory complications in patients with cystic fibrosis (CF) have improved median survival and resulted in gastrointestinal complications becoming more evident.1,2 The distal intestinal obstruction syndrome (DIOS) develops due to the accumulation of viscid muco-faeculent material in the terminal ileum and right hemicolon.3 Reduced intestinal water content, lower luminal acidity of the foregut, and accumulation of intraluminal macromolecules contribute to the development of DIOS.4 Typically, patients develop progressive symptoms and signs of small bowel obstruction. A plain abdominal x ray will reveal dilated loops of centrally placed small bowel, with faecal loading at the terminal ileum and right hemicolon (see fig 1). Most cases will respond to the aggressive use of laxative agents administered orally and rectally, intravenous hydration, pancreatic supplements, and N-acetylcysteine (Parvolex) and gastrografin (meglumine diatrizoate) orally or per rectum.5–,8 Surgical decompression has been reserved for refractory cases but carries …

View Full Text