Treatment of Distal Intestinal Obstruction Syndrome

The distal intestinal obstruction syndrome (DIOS), previously known as meconium ileus equivalent (MIE), is a condition unique to cystic fibrosis (CF). The syndrome is relatively common, occurring in about 10-22% of patients (Rubinstein et al, 1986; Penketh et al, 1987; Davidson et al, 1987; Dray et al, 2004). It may present at any time after the neonatal period but the incidence increases with age and it is more common in adolescent and adult patients. About 80% of cases present for the first time in adults. The recurrence rate is approximately 50%. Treatment of distal intestinal obstruction syndrome is easily misdiagnosed by those who are not familiar with the condition. It has not been described in other forms of pancreatic insufficiency but it has been reported in patients with cystic fibrosis who are pancreatic sufficient and have normal fat absorption (Davidson et al, 1987; Millar-Jones et al, 1995).