Management of malignant bowel obstruction

Ripamonti, Carla; Easson, Alexandra; Gerdes, Hans

doi:10.1016/j.ejca.2008.02.028

Cited by 225 publications

(226 citation statements)

References 68 publications

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“…The parenteral route is utilised due to the unpredictability of absorption of oral medications. For exacerbations of colic, the antispasmodic hyoscine butylbromide is of benefit and less sedating than hyoscine hydrobromide (Anthony et al, 2007;Ripamonti et al, 2008 Level IV). Decompression and reduction in secretions may also assist with pain.…”

Section: Malignant Bowel Obstructionmentioning

confidence: 99%

Acupuncture for analgesia in the emergency department: a multicentre, randomised, equivalence and non‐inferiority trial

Cohen

Smit

Andrianopoulos³

et al. 2017

Medical Journal of Australia

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Objectives: This study aimed to assess analgesia provided by acupuncture, alone or in combination with pharmacotherapy, to patients presenting to emergency departments with acute low back pain, migraine or ankle sprain. Design: A pragmatic, multicentre, randomised, assessor‐blinded, equivalence and non‐inferiority trial of analgesia, comparing acupuncture alone, acupuncture plus pharmacotherapy, and pharmacotherapy alone for alleviating pain in the emergency department. Setting, participants: Patients presenting to emergency departments in one of four tertiary hospitals in Melbourne with acute low back pain, migraine, or ankle sprain, and with a pain score on a 10‐point verbal numerical rating scale (VNRS) of at least 4. Main outcome measures: The primary outcome measure was pain at one hour (T1). Clinically relevant pain relief was defined as achieving a VNRS score below 4, and statistically relevant pain relief as a reduction in VNRS score of greater than 2 units. Results: 1964 patients were assessed between January 2010 and December 2011; 528 patients with acute low back pain (270 patients), migraine (92) or ankle sprain (166) were randomised to acupuncture alone (177 patients), acupuncture plus pharmacotherapy (178) or pharmacotherapy alone (173). Equivalence and non‐inferiority of treatment groups was found overall and for the low back pain and ankle sprain groups in both intention‐to‐treat and per protocol (PP) analyses, except in the PP equivalence testing of the ankle sprain group. 15.6% of patients had clinically relevant pain relief and 36.9% had statistically relevant pain relief at T1; there were no between‐group differences. Conclusion: The effectiveness of acupuncture in providing acute analgesia for patients with back pain and ankle sprain was comparable with that of pharmacotherapy. Acupuncture is a safe and acceptable form of analgesia, but none of the examined therapies provided optimal acute analgesia. More effective options are needed. Trial registration: Australian New Zealand Clinical Trials Registry, ACTRN12609000989246.

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Section: Malignant Bowel Obstructionmentioning

confidence: 99%

Acupuncture for analgesia in the emergency department: a multicentre, randomised, equivalence and non‐inferiority trial

Cohen

Smit

Andrianopoulos³

et al. 2017

Medical Journal of Australia

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“…MBO is a common palliative care problem, encountered in 5-51% of patients with ovarian cancer, 10-28% of patients with colorectal cancer and 3-15% of patients with other types of cancer (1,2,(5)(6)(7)(8). In our study, the type of cancer most commonly responsible for MBO was found to be colorectal adenocarcinoma (55%).…”

Section: Discussionmentioning

confidence: 68%

“…Although it may occur at any stage, it is most commonly associated with end-stage cancer (1). Retrospective reviews demonstrated that 10-50% of patients with advanced cancer stage will develop MBO during the course of their disease and suffer from intractable abdominal pain, nausea and vomiting, which result in a poor quality of life (QOL), mental and emotional problems (2). Multimodality treatments, including surgery, palliative radiotherapy, chemotherapy and total parenteral nutrition formulas, may be used to relieve the symptoms in patients with MBO; however, there is currently no consensus regarding the optimal treatment strategy and no strong evidence supporting the efficacy of any treatment in improving QOL and prolonging survival.…”

Section: Introductionmentioning

confidence: 99%

Malignant bowel obstruction: A retrospective clinical analysis

Chen

Huang

Chang

et al. 2013

Molecular and Clinical Oncology

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Abstract. Malignant bowel obstruction (MBO) is a disease with a poor prognosis, particularly in patients with advanced bowel or gynecological cancers. Multimodality teatments may be used to relieve the symptoms in patients with MBO; however, there is currently no consensus regarding the optimal treatment and no strong evidence supporting the efficacy of any treatment in improving the quality of life (QOL) and prolonging survival. We conducted a search through our medical center database of cancer registries for MBO cases between January, 1995 and December, 2008 and analyzed the clinicopathological characteristics and association between treatments and prognosis or QOL. The primary type of cancer causing MBO was found to be adenocarcinoma of colon. The overall survival time was found to be significantly higher among patients presenting with MBO as the initial symptom and improved QOL was achieved in patients who received surgical treatment. The mean survival time and the functional status of colorectal cancer patients receiving targeted therapy and chemotherapy were more satisfactory compared with those receiving surgery alone or conservative treatment. Furthermore, for end-stage cancer patients with MBO, hospice care was effective in reducing pain scores and relieving the symptoms of the disease. IntroductionMalignant bowel obstruction (MBO) is a disease with a poor prognosis, particularly in patients with advanced bowel or gynecological cancers. Although it may occur at any stage, it is most commonly associated with end-stage cancer (1). Retrospective reviews demonstrated that 10-50% of patients with advanced cancer stage will develop MBO during the course of their disease and suffer from intractable abdominal pain, nausea and vomiting, which result in a poor quality of life (QOL), mental and emotional problems (2). Multimodality treatments, including surgery, palliative radiotherapy, chemotherapy and total parenteral nutrition formulas, may be used to relieve the symptoms in patients with MBO; however, there is currently no consensus regarding the optimal treatment strategy and no strong evidence supporting the efficacy of any treatment in improving QOL and prolonging survival. Materials and methodsPatient records. In order to evaluate the clinical presentation, treatment options and survival of MBO patients, we searched the TSGH database of cancer registries for MBO cases between January, 1995 and December, 2008 and analyzed the clinicopathological characteristics and the association between treatments and prognosis or QOL. The clinical information and diagnostic results were extracted from the medical records, including demographic data, clinical manifestations, physical examination, radiological findings, laboratory results and pathology reports. Non-malignant causes of obstruction, such as adhesions from previous surgery, hernia, volvulus, inflammatory bowel disease, fecal impaction and bowel ischemia were excluded from this study.Functional status. The change in patients' functional status following treat...

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“…Other drug groups used in patients with neuropathic pain component comprise local anesthetics and antiarrhytmics (Freynhagen & Bennett, 2009). Opioid analgesics should be supplemented with spasmolytics in patients with visceral colicky pain, especially in the course of bowel obstruction (Ripamonti et al, 2008).…”

Section: Omentioning

confidence: 99%

The Role of Opioid Analgesics in the Treatment of Pain in Cancer Patients

Leppert¹

2012

Pain Management - Current Issues and Opinions

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Management of malignant bowel obstruction

Cited by 225 publications

References 68 publications

Acupuncture for analgesia in the emergency department: a multicentre, randomised, equivalence and non‐inferiority trial

Acupuncture for analgesia in the emergency department: a multicentre, randomised, equivalence and non‐inferiority trial

Malignant bowel obstruction: A retrospective clinical analysis

The Role of Opioid Analgesics in the Treatment of Pain in Cancer Patients

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