Bowel obstruction in the terminally ill is a relatively common complication. The classic therapy of IV hydration with nasogastric suction is contraindicated due to inefficacy and patient discomfort. Modern therapy consists of state-of-the-art pharmacologic treatments, as well as the judicious use of surgical interventions in selected cases. Many patients can be relatively symptom-free and can eat and drink as tolerated.
Get full access to this article
View all access options for this article.
References
1.
Baines M: The pathophysiology and management of malignant intestinal obstruction. In Oxford Textbook of Palliative Medicine. Oxford: Oxford University Press, 1993: 311-316.
2.
Krebs HB, Helmkamp BF: Management of Intestinal Obstruction in Ovarian Cancer. Oncology. 1989;3(5): 25.
3.
Spears Het al: Treatment of bowel obstruction after operation for colorectal carcinoma. Am J Surg. 1988;155:383.
4.
Baines Met al:Medical management of intestinal obstruction in patients with advanced malignant disease: A clinical and pathological study. Lancet. 1985;2:990.
5.
Fainsinger RLet al: Symptom control in terminally ill patients with malignant bowel obstruction. J Pain and Symptom Mgt. 1994;9(1): 12.
6.
Krebs Het al: Surgical management of bowel obstruction in advanced ovarian cancer. Obst and Gyn. 1983;61:327.
7.
Baines MJ: Nausea, vomiting, and intestinal obstruction. BMJ. 1997;315:1148.
8.
Ripamonti Cet al: Management of bowel obstruction in advanced and terminal cancer patients. Ann Oncol. 1993;4:15.
9.
Tang Eet al: Bowel obstruction in cancer patients. Arch Surg. 1995;130:832.
10.
Malone JMet al: Palliation of small bowel obstruction by percutaneous gastrostomy in patients with progressive ovarian carcinoma. Obst and Gyn. 1986;68:431.
11.
In Wook Chooet al: Malignant colorectal obstruction: treatment with a flexible covered stent. Radiology. 1998;206:415.
12.
Binkert CAet al: Acute colonic obstruction: clinical aspects and cost-effectiveness of preoperative and palliative treatment with self-expanding metallic stents—a preliminary report. Radiology. 1998;206:199.
13.
Willimann Het al: Lecithin organogel as matrix for transdermal transport of drugs. J Pharmaceut Sci. 1992;81(9): 871.
14.
Mercadante Set al: Octreotide in relieving gastrointestinal symptoms due to bowel obstruction. Palliative Med. 1993;7:42.
15.
Frank C: Medical management of intestinal obstruction in terminal care. Can Fam Phys. 1997;43:259.
16.
Mangili Get al: Octreotide in the management of bowel obstruction in terminal ovarian cancer. Gyn Oncology. 1996;61(3):345.
17.
Miscellaneous Gastrointestinal Agents. In AMA Drug Evaluations. Fifth edition. Chicago, American Medical Association, 1983; 1325-1338.
18.
Farr WC: The use of corticosteroids for symptom management in terminally ill patients. Am J Hospice and Palliat Care. 1990;7(1): 41.
19.
Billings JA: Comfort measures for the terminally ill-is dehydration painful?J Am Ger Soc. 1985;33:808.
