Jeffrey Berger1, Paula Lester2, Lucan Rodrigues3. 1. Divisions of Palliative Medicine and Geriatrics, Winthrop University Hospital, Mineola, NY, USA. 2. Divisions of Geriatrics and Palliative Medicine, Winthrop University Hospital, Mineola, NY, USA. 3. Division of Palliative Care, Flushing Hospital, Flushing, NY, USA lrodrigues615@gmail.com.
Abstract
BACKGROUND: Malignant bowel obstruction is a highly symptomatic, often recurrent, and sometimes refractory condition in patients with intra-abdominal tumor burden. Gastro-intestinal symptoms and function may improve with anti-inflammatory, anti-secretory, and prokinetic/anti-nausea combination medical therapy. OBJECTIVE: To describe the effect of octreotide, metoclopramide, and dexamethasone in combination on symptom burden and bowel function in patients with malignant bowel obstruction and dysfunction. DESIGN: A retrospective case series of patients with malignant bowel obstruction (MBO) and malignant bowel dysfunction (MBD) treated by a palliative care consultation service with octreotide, metoclopramide, and dexamethasone. Outcomes measures were nausea, pain, and time to resumption of oral intake. RESULTS: 12 cases with MBO, 11 had moderate/severe nausea on presentation. 100% of these had improvement in nausea by treatment day #1. 100% of patients with moderate/severe pain improved to tolerable level by treatment day #1. The median time to resumption of oral intake was 2 days (range 1-6 days) in the 8 cases with evaluable data. Of 7 cases with MBD, 6 had For patients with malignant bowel dysfunction, of those with moderate/severe nausea. 5 of 6 had subjective improvement by day#1. Moderate/severe pain improved to tolerable levels in 5/6 by day #1. Of the 4 cases with evaluable data on resumption of PO intake, time to resume PO ranged from 1-4 days. CONCLUSION: Combination medical therapy may provide rapid improvement in symptoms associated with malignant bowel obstruction and dysfunction.
BACKGROUND:Malignant bowel obstruction is a highly symptomatic, often recurrent, and sometimes refractory condition in patients with intra-abdominal tumor burden. Gastro-intestinal symptoms and function may improve with anti-inflammatory, anti-secretory, and prokinetic/anti-nausea combination medical therapy. OBJECTIVE: To describe the effect of octreotide, metoclopramide, and dexamethasone in combination on symptom burden and bowel function in patients with malignant bowel obstruction and dysfunction. DESIGN: A retrospective case series of patients with malignant bowel obstruction (MBO) and malignant bowel dysfunction (MBD) treated by a palliative care consultation service with octreotide, metoclopramide, and dexamethasone. Outcomes measures were nausea, pain, and time to resumption of oral intake. RESULTS: 12 cases with MBO, 11 had moderate/severe nausea on presentation. 100% of these had improvement in nausea by treatment day #1. 100% of patients with moderate/severe pain improved to tolerable level by treatment day #1. The median time to resumption of oral intake was 2 days (range 1-6 days) in the 8 cases with evaluable data. Of 7 cases with MBD, 6 had For patients with malignant bowel dysfunction, of those with moderate/severe nausea. 5 of 6 had subjective improvement by day#1. Moderate/severe pain improved to tolerable levels in 5/6 by day #1. Of the 4 cases with evaluable data on resumption of PO intake, time to resume PO ranged from 1-4 days. CONCLUSION: Combination medical therapy may provide rapid improvement in symptoms associated with malignant bowel obstruction and dysfunction.
Authors: Declan Walsh; Mellar Davis; Carla Ripamonti; Eduardo Bruera; Andrew Davies; Alex Molassiotis Journal: Support Care Cancer Date: 2016-08-17 Impact factor: 3.603
Authors: Jolene Si Min Wong; Sze Min Lek; Daniel Yan Zheng Lim; Claramae Shulyn Chia; Grace Hwei Ching Tan; Chin-Ann Johnny Ong; Melissa Ching Ching Teo Journal: Front Oncol Date: 2022-01-13 Impact factor: 6.244
Authors: Sarah B Bateni; Alicia A Gingrich; Amanda R Kirane; Candice A M Sauder; Sepideh Gholami; Richard J Bold; Frederick J Meyers; Robert J Canter Journal: Ann Surg Oncol Date: 2021-04-07 Impact factor: 5.344
Authors: Ainhoa Madariaga; Jenny Lau; Arunangshu Ghoshal; Tomasz Dzierżanowski; Philip Larkin; Jacek Sobocki; Andrew Dickman; Kate Furness; Rouhi Fazelzad; Gregory B Crawford; Stephanie Lheureux Journal: Support Care Cancer Date: 2022-03-10 Impact factor: 3.359