Paliatívna medicína a liečba bolesti 1-2e/2017

Conservative treatment of malignant bowel obstruction

Bowel obstruction is a frequent complication in patients with advanced tumor disease. It is a complete or partial disruption of bowel contents movement. Most frequent clinical symptoms are pain, nausea, vomiting and obstipation. In differential diagnostics it is necesary to exclude primarily benign cases of bowel obstruction. Due to overall conditions or disease advance some patients are not suitable candidates for surgical procedures and could benefit from symptomatic treatment. One of the main aims of MBO (malignant bowel obstruction) symptomatic treatment, that include also antiemetics, antisecretory treatment and analgetics, is the nasogastric tube removal, ev. management of symptom palliation without a use of the tube. Home parenteral nutrition should be considered for specific patient group, beside others when the patient is in danger of dying as a result of starving not due to the progression of tumor disease.

Keywords: malignant bowel obstruction, nausea and vomiting, antisecretory treatment, octreotide, home parenteral nutrition