Pharmacological treatment of bowel obstruction in cancer patients.

Hdl Handle:
http://hdl.handle.net/10147/207952
Title:
Pharmacological treatment of bowel obstruction in cancer patients.
Authors:
O'Connor, Brenda; Creedon, Brian
Affiliation:
Waterford Regional Hospital, Department of Palliative Medicine, Waterford,, Ireland. oconnorbren@hotmail.com
Citation:
Expert Opin Pharmacother. 2011 Oct;12(14):2205-14. Epub 2011 Jun 30.
Journal:
Expert opinion on pharmacotherapy
Issue Date:
1-Feb-2012
URI:
http://hdl.handle.net/10147/207952
DOI:
10.1517/14656566.2011.597382
PubMed ID:
21714777
Abstract:
INTRODUCTION: Malignant bowel obstruction (MBO) is a common complication of advanced cancer, occurring most frequently in gynaecological and colorectal cancer. Its management remains complex and variable. This is in part due to the lack of evidence-based guidelines for the clinicians involved. Although surgery should be considered the primary treatment, this may not be feasible in patients with a poor performance status or advanced disease. Advances have been made in the medical management of MBO which can lead to a considerable improvement in symptom management and overall quality of life. AREAS COVERED: This review emphasizes the importance of a prompt diagnosis of MBO with early introduction of pharmacological agents to optimize symptom control. The authors summarize the treatment options available for bowel obstruction in those patients for whom surgical intervention is not a feasible option. The authors also explore the complexities involved in the introduction of parenteral hydration and total parenteral nutrition in this group of patients. EXPERT OPINION: 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.
Language:
eng
MeSH:
Adrenal Cortex Hormones/administration & dosage/therapeutic use; Analgesics/administration & dosage/therapeutic use; Cholinergic Antagonists/administration & dosage/therapeutic use; Fluid Therapy; Gastrointestinal Agents/administration & dosage/therapeutic use; Humans; Intestinal Obstruction/diagnosis/drug therapy/surgery/*therapy; Neoplasms/*complications; Palliative Care/*methods; Parenteral Nutrition, Total
ISSN:
1744-7666 (Electronic); 1465-6566 (Linking)

Full metadata record

DC FieldValue Language
dc.contributor.authorO'Connor, Brendaen_GB
dc.contributor.authorCreedon, Brianen_GB
dc.date.accessioned2012-02-01T10:52:24Z-
dc.date.available2012-02-01T10:52:24Z-
dc.date.issued2012-02-01T10:52:24Z-
dc.identifier.citationExpert Opin Pharmacother. 2011 Oct;12(14):2205-14. Epub 2011 Jun 30.en_GB
dc.identifier.issn1744-7666 (Electronic)en_GB
dc.identifier.issn1465-6566 (Linking)en_GB
dc.identifier.pmid21714777en_GB
dc.identifier.doi10.1517/14656566.2011.597382en_GB
dc.identifier.urihttp://hdl.handle.net/10147/207952-
dc.description.abstractINTRODUCTION: Malignant bowel obstruction (MBO) is a common complication of advanced cancer, occurring most frequently in gynaecological and colorectal cancer. Its management remains complex and variable. This is in part due to the lack of evidence-based guidelines for the clinicians involved. Although surgery should be considered the primary treatment, this may not be feasible in patients with a poor performance status or advanced disease. Advances have been made in the medical management of MBO which can lead to a considerable improvement in symptom management and overall quality of life. AREAS COVERED: This review emphasizes the importance of a prompt diagnosis of MBO with early introduction of pharmacological agents to optimize symptom control. The authors summarize the treatment options available for bowel obstruction in those patients for whom surgical intervention is not a feasible option. The authors also explore the complexities involved in the introduction of parenteral hydration and total parenteral nutrition in this group of patients. EXPERT OPINION: 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.en_GB
dc.language.isoengen_GB
dc.subject.meshAdrenal Cortex Hormones/administration & dosage/therapeutic useen_GB
dc.subject.meshAnalgesics/administration & dosage/therapeutic useen_GB
dc.subject.meshCholinergic Antagonists/administration & dosage/therapeutic useen_GB
dc.subject.meshFluid Therapyen_GB
dc.subject.meshGastrointestinal Agents/administration & dosage/therapeutic useen_GB
dc.subject.meshHumansen_GB
dc.subject.meshIntestinal Obstruction/diagnosis/drug therapy/surgery/*therapyen_GB
dc.subject.meshNeoplasms/*complicationsen_GB
dc.subject.meshPalliative Care/*methodsen_GB
dc.subject.meshParenteral Nutrition, Totalen_GB
dc.titlePharmacological treatment of bowel obstruction in cancer patients.en_GB
dc.contributor.departmentWaterford Regional Hospital, Department of Palliative Medicine, Waterford,, Ireland. oconnorbren@hotmail.comen_GB
dc.identifier.journalExpert opinion on pharmacotherapyen_GB
dc.description.provinceMunster-

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