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    Pharmacological treatment of bowel obstruction in cancer patients.

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    Authors
    O'Connor, Brenda
    Creedon, Brian
    Affiliation
    Waterford Regional Hospital, Department of Palliative Medicine, Waterford,, Ireland. oconnorbren@hotmail.com
    Issue Date
    2012-02-01T10:52:24Z
    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
    
    Metadata
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    Citation
    Expert Opin Pharmacother. 2011 Oct;12(14):2205-14. Epub 2011 Jun 30.
    Journal
    Expert opinion on pharmacotherapy
    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
    ISSN
    1744-7666 (Electronic)
    1465-6566 (Linking)
    ae974a485f413a2113503eed53cd6c53
    10.1517/14656566.2011.597382
    Scopus Count
    Collections
    University Hospital Waterford

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