News from Joey: this morning the radiologist reassed the CT scan. They figured that the colon is clear, but Joey has DIOS (distal intestinal obstruction syndrome), but not a really bad case. He is now on clear fluids to give his bowels a rest and will see the GI tomorrow.
Should be interesting to be on a clear fluid diet when he’s on fluid restrictions…
PS If you’re wondering what DIOS is, I found this explanation on www.cysticfibrosismedicine.com
The distal intestinal obstruction syndrome (DIOS) is a unique condition to cystic fibrosis (CF). It occurs due to the accumulation of viscous mucous and faecal material in the terminal ileum, caecum and ascending colon. Typically patients develop progressive symptoms of recurrent colicky abdominal pain, bloating, nausea and anorexia, and signs of small intestinal obstruction. It has not been described in other forms of pancreatic insufficiency although it has been reported in patients with cystic fibrosis who are pancreatic sufficient and have normal fat absorption (Millar-Jones et al, 1995, Davidson et al, 1987).
The syndrome is relatively common, occurring in about 10-20% of patients (Penketh et al, 1987, Davidson et al, 1987, Rubinstein et al, 1986). It may present either acutely or chronically and can be easily misdiagnosed by those who are unaware of the condition. DIOS may occur at any time after the neonatal period and the incidence appears to increase with age and to be more common in adolescent and adult patients. Contributing factors include fat malabsorption (Andersen et al, 1990), abnormal intestinal mucins, low duodenal pH, low dietary fibre intake, possibly a prolonged transit time, previous meconium ileus, abnormal intestinal water and electrolyte transport, and anticholinergic drugs (Eggermont 1996, Wilschanski et al, 1998). Dehydration associated with the development of diabetes mellitus may also precipitate DIOS (Hodson et al, 1976).
DIOS is a well recognised complication in the early post transplant period. It occurs with increasing frequency due to dehydration and drug therapy. Effective preventative measures and early treatment are important if severe complications are to be avoided (Gilljam et al, 2003).