Pharmacological treatment of bowel obstruction in cancer patients

Abstract

It is not always easy to distinguish reversible from irreversible bowel obstruction. Early and aggressive management with the introduction of pharmacological agents including corticosteroids, octreotide and anti-cholinergic agents have the potential to maintain bowel patency, and allow for more rapid recovery of bowel transit. A combination of analgesics, anti-emetics and anti-cholinergics with or without anti-secretory agents can successfully improve symptom control in patients with irreversible bowel obstruction.

Clinical Impact of Palliative Treatment Using Octreotide for Inoperable Malignant Bowel Obstruction Caused by Advanced Urological Cancer

“…The efficacy of octreotide in controlling the symptoms of MBO has been shown in several reports (Davis and Nouneh, 2000;Ripamonti and Mercadante, 2005;Mercadante et al, 2007;O'Connor and Creedon, 2011;Mercadante and Porzio, 2012).…”

“…However, the effects of octreotide and corticosteroids on MBO have not been compared. Further research is needed to examine the role of corticosteroids in MBO treatment (Mercadante et al, 2007;O'Connor and Creedon, 2011). Combination therapy of octreotide and corticosteroids has been studied empirically, but there is not enough data to support its efficacy.…”

“…However, vomiting can increase due to excess infusion volume (Philip and Depczynski, 1997). Therefore, the use of hydration remains controversial and should be decided on individual basis (O'Connor and Creedon, 2011). Combined use of intravenous fluids and octreotide is recommended because the efficacy of intravenous fluids alone is limited.…”

Emergency Surgery for Colorectal Cancer Complications: Obstruction, Perforation, Bleeding

“…Also, prophylaxis of deep venous thrombosis prophylaxis is achieved with low molecular weight heparin. Symptomatic treatment may be given to relieve the distress and may includes, analgesics, antiemetics, gastric antisecretion drugs and anticholinergics (6).…”

Metronomic Chemotherapy with 5-Fluorouracil and Cisplatin for Inoperable Malignant Bowel Obstruction Because of Peritoneal Dissemination from Gastric Cancer

“…Medical measures such as analgesics can be used to relieve continuous abdominal pain 7 . Vomiting can be controlled using anti-secretory drugs, antiemetics, or both 8 . Somatostatin analogues (for example, octreotide or lanreotide) block the release of vasoactive intestinal polypeptide, which rises in mbo 9,10 .…”