Bowel obstruction in home-care cancer patients: 4 years experience

Support Care Cancer. 1995 May;3(3):190-3. doi: 10.1007/BF00368889.

Abstract

Conservative management of bowel obstruction in advanced cancer patients has been recognized as efficacious in controlling distressing symptoms such as nausea, vomiting and pain. A retrospective analysis of prevalence, treatment and outcome was performed. A group of 25 patients with signs of bowel obstruction were studied from 1001 consecutive patients receiving palliative care at home. A score for total distress was calculated to assess the gastrointestinal symptoms at diagnosis, after 1 week of treatment and 1 day before death. The mean survival was 19 days. Six patients were admitted to hospital, 3 of whom underwent surgery and died in the immediate postoperative period. The patients diagnosed in hospital and discharged received a nasogastric tube (7 cases) and a central venous line. The nasogastric tube was removed after gastrointestinal secretions had been controlled by a combination of drugs, and parenteral nutrition or hydration, mainly started in hospital, was discontinued only a few days before death (13 cases, mean duration 19 days). The distress symptom score was statistically reduced after 1 week of treatment and on the day before death when compared to the referral time. The most frequent combination of drugs was octreotide, haloperidol and low doses of morphine. A subcutaneous route was preferred for administering the drugs. Utilization of a wide range of drugs permits good symptom control for bowel obstruction in patients followed at home.

MeSH terms

  • Abdominal Neoplasms / complications*
  • Adult
  • Aged
  • Catheterization, Central Venous
  • Female
  • Fluid Therapy
  • Follow-Up Studies
  • Haloperidol / therapeutic use
  • Home Care Services, Hospital-Based*
  • Humans
  • Intestinal Obstruction / drug therapy*
  • Intubation, Gastrointestinal
  • Male
  • Middle Aged
  • Morphine / therapeutic use
  • Octreotide / therapeutic use
  • Palliative Care
  • Parenteral Nutrition
  • Patient Admission
  • Patient Discharge
  • Retrospective Studies
  • Survival Rate
  • Treatment Outcome

Substances

  • Morphine
  • Haloperidol
  • Octreotide