Treatment of Intestinal Blockages in Cystic Fibrosis in Children
Constipation and intestinal blockages, called meconium ileus in newborns or distal intestinal obstructive syndrome in older children, are common complications in children who have cystic fibrosis. Signs of meconium ileus may appear on a prenatal ultrasound or may be suspected when a newborn does not pass stool. Doctors at Hassenfeld Children’s Hospital at NYU Langone are experienced in evaluating these complications and in selecting the best treatment.
To confirm that an infant has meconium ileus, our doctors may use an enema that contains a special laxative solution combined with a contrast agent, which can help show any intestinal blockage on an ultrasound. Because the solution draws water into the intestine, it often flushes out the material causing the blockage. If the enema clears out the blockage, no additional treatment is needed.
Surgery for Intestinal Blockage
If your baby still has an intestinal blockage after an enema, our surgeons may perform an exploratory surgical procedure to examine the intestine.
If the obstruction has not damaged the bowel tissue, the surgeon may insert a catheter into the intestine to flush it out with saline or a laxative solution. Most babies recover from this procedure in one to two days.
If the blockage has damaged the bowel wall, the surgeon may need to perform an operation to remove a portion of the intestine. Sometimes, the surgeon can immediately reconnect the healthy sections of the bowel during the same procedure. If the bowel needs a few weeks to heal, the surgeon may need to create a temporary opening in the abdomen, called a stoma, so that the baby’s bowel can function normally until a second procedure can be performed to reconnect the bowel and restore normal bowel function.
If the surgery is extensive, our doctors often recommend intravenous (IV) nutrition, which ensures that your baby receives nutrients and fluids through a special catheter that is placed in a vein. An IV can be started in the hospital and continued at home for as long as it takes for the bowel to regain its ability to absorb nutrients.
Bowel obstruction, or distal intestinal obstructive syndrome, is a complication in older children with cystic fibrosis who take pancreatic enzymes to improve digestion. However, constipation can occur from time to time, especially in older children who are being treated with pain medications. Gastroenterologists may prescribe enemas or bowel-cleansing medications to help relieve this symptom.