Distal intestinal obstruction syndrome (DIOS) secondary to cystic fibrosis

There are no RCTs of oral or rectal acetylcysteine for DIOS associated with cystic fibrosis. The ESPGHAN Cystic Fibrosis Working Group recommend use of acetylcysteine administered orally has been superseded by diatrizoic acid (Gastrografin) in children with an acute episode of DIOS [12]. Oral osmotic laxatives containing polyethylene glycol (PEG) or lactulose are recommended alternatives when needed for prophylaxis against DIOS. [12] A recent review of acetylcysteine for management of DIOS found administration technique and monitoring parameters are not well defined in current literature and clinical trials are lacking and would be helpful to better define the role of acetylcysteine in distal intestinal obstruction syndrome [13].