Interventions for preventing distal intestinal obstruction syndrome (DIOS) in cystic fibrosis

Carroll, Will; Green, Jessica; Gilchrist, Francis J

Abstract

Background
Cystic fibrosis (CF) is the most common, life‐limiting, genetically inherited disease. It affects multiple organs, particularly the respiratory system. However, gastrointestinal problems such as constipation and distal intestinal obstruction syndrome (DIOS) are also important and well‐recognised complications in CF. They share similar symptoms e.g. bloating, abdominal pain, but are distinct conditions. Constipation occurs when there is gradual faecal impaction of the colon, but DIOS occurs when there is an accumulation of faeces and sticky mucus, forming a mass in the distal part of the small intestine. The mass may partially block the intestine (incomplete DIOS) or completely block the intestine (complete DIOS). Symptoms of DIOS can affect quality of life and other aspects of CF health, such as airway clearance, exercise, sleep and nutritional status. Treatment of constipation and prevention of complete bowel obstruction are required for gastrointestinal management in CF. However, many different strategies are used in clinical practice and there is a lack of consensus. The importance of this topic was highlighted in a recent research priority setting exercise by the James Lind Alliance.

Objectives
To evaluate the effectiveness and safety of laxative agents of differing types for preventing DIOS (complete and incomplete) in children and adults with CF.

Citation

Carroll, W., Green, J., & Gilchrist, F. J. (in press). Interventions for preventing distal intestinal obstruction syndrome (DIOS) in cystic fibrosis. Cochrane Database of Systematic Reviews, 2021(12), https://doi.org/10.1002/14651858.cd012619.pub3

• Journal Article Type: Article
• Acceptance Date: Dec 22, 2021
• Online Publication Date: Dec 22, 2021
• Deposit Date: Jun 19, 2023
• Journal: Cochrane Database of Systematic Reviews
• Publisher: Cochrane Collaboration
• Peer Reviewed: Peer Reviewed
• Volume: 2021
• Issue: 12
• DOI: https://doi.org/10.1002/14651858.cd012619.pub3
• Keywords: Pharmacology (medical)