what is the treatment for Malignant bowel obstruction

what is the treatment for Malignant bowel obstruction

what is the treatment for Malignant bowel obstruction

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Malignant Bowel Obstruction
Malignant bowel obstruction(MBO)refers to reduced or absent propulsion of gastric and intestinal contents through the gut that is usually brought about by advanced malignancies such as colorectal and ovarian cancer (Krouse, 2019). Patients with malignant bowel obstruction will present with gastrointestinal disturbances such as abdominal pain, nausea and vomiting. This paper will discuss the available treatment modalities for malignant bowel obstruction.
A patient with MBO should first have a nasogastric tube (NGT) inserted in order to decompress the stomach and prevent aspiration of the stomach contents. Intravenous fluid should also be administered to replenish the intravascular fluid loss and prevent electrolyte imbalance. Medical management of patients with MBO includes the administration of analgesics such as opioids for pain, use of anti-emetics andintravenous steroids to reduce inflammation. Antisecretory drugs such as octreotide can also be used to decrease gastric secretions. Surgery is the primary treatment option for most patients with MBO.Proximal diversions and bowel resection with anastomosis or bypass are some of the most common surgical procedures performed on patients with MBO (Franke et al., 2017). This however should be done with caution and should be avoided in those patients who have a poor prognosis following surgical interventions such as patients with ascites, those with complete small bowel obstruction and leukocytosis.
Stenting with a self-expanding metal stents is also a possible intervention even though it is not widely used (Franke et al., 2017). This option should be considered for patients who are unfit for surgery or those who don’t wish to undergo surgery. It is also associated with reduced costs, mortality and morbidity rates. Radiological imaging is also a helpful tool not only in making a diagnosis but also as a mode of treatment. Management of malignant bowel obstruction usually requires a multidisciplinary approach. Patients should always be involved in the discussion of their treatment plan.

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References.
Franke, A. J., Iqbal, A., Starr, J. S., Nair, R. M., & George, T. J. (2017). Management of Malignant Bowel Obstruction Associated with GI Cancers. Journal of Oncology Practice, 13(7), 426–434. https://doi.org/10.1200/JOP.2017.022210
Krouse, R. S. (2019). Malignant bowel obstruction. Journal of Surgical Oncology, 120(1), 74–77. https://doi.org/10.1002/jso.25451

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