Friday, March 21, 2008

Understanding Meconium Ileus

Meconium ileus is one of the prevalent first signs of cystic fibrosis in infants. 1 in 5 people with cystic fibrosis have undergone treatment for meconium ileus. Meconium refers to a baby’s first bowel movement. Often it is greenish in color, and has built up in the infant’s bowels prior to birth. Normally this material is expelled early on. In babies with CF however, the thick, sticky mucus present in the intestines prevents the thick, tar-like meconium from moving. It remains in the bowel, causing an obstruction and a bloated abdomen. In many cases surgery is required to remove the blockage.

The blockage, which accumulates at the lower end of the small intestine (i.e., the ileum) must be removed to prevent damage to the bowel. Treatment for meconium ileus depends on the severity of the blockage. Early detection using an x-ray or CT scan helps determine whether treatment will require surgery or simply a strong course of mucolytics.

-What is an Ileostomy?-

Treating meconium ileus with surgery requires that the blocked portion of the intestine be removed. In order for them to heal properly from the procedure, an ileostomy must be done. An ileostomy is the technical term for the surgery in which an opening in the abdomen, called a “stoma” is created. The ileus, which is the end portion of the small intestine, is brought through the stoma. A small bag is placed at the site and taped to the skin. Fecal material is excreted into the bag instead of at the anus.

Once the intestine heals and blockage is no longer a risk, another surgery called an “ostomy reversal” is done to put everything back together inside the body. The first bowel movements upon reversal are quite frequent. It’s normal to have several per day, possibly in excess of 10.

-Life After Ostomy-

CF patients who have undergone an ileostomy and reversal must consider carefully the foods they eat. Failure to absorb nutrients and vitamins from food is a common problem for all CF patients who are pancreatic insufficient. Those who have had bowel surgeries should take extra care to make sure they eat enough calories per day to off-set the nutritional loss that occurs as the result of frequent stools.

Maintaining adequate hydration is also key, since people who have had intestinal blockages in the past are most likely to experience them again.

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