• Jeffrey Berger, Paula Lester, and Lucan Rodrigues.
• Divisions of Palliative Medicine and Geriatrics, Winthrop University Hospital, Mineola, NY, USA.
• Am J Hosp Palliat Care. 2016 May 1; 33 (4): 407-10.

BackgroundMalignant bowel obstruction is a highly symptomatic, often recurrent, and sometimes refractory condition in patients with intra-abdominal tumor burden. Gastro-intestinal symptoms and function may improve with anti-inflammatory, anti-secretory, and prokinetic/anti-nausea combination medical therapy.ObjectiveTo describe the effect of octreotide, metoclopramide, and dexamethasone in combination on symptom burden and bowel function in patients with malignant bowel obstruction and dysfunction.DesignA retrospective case series of patients with malignant bowel obstruction (MBO) and malignant bowel dysfunction (MBD) treated by a palliative care consultation service with octreotide, metoclopramide, and dexamethasone. Outcomes measures were nausea, pain, and time to resumption of oral intake.Results12 cases with MBO, 11 had moderate/severe nausea on presentation. 100% of these had improvement in nausea by treatment day #1. 100% of patients with moderate/severe pain improved to tolerable level by treatment day #1. The median time to resumption of oral intake was 2 days (range 1-6 days) in the 8 cases with evaluable data. Of 7 cases with MBD, 6 had For patients with malignant bowel dysfunction, of those with moderate/severe nausea. 5 of 6 had subjective improvement by day#1. Moderate/severe pain improved to tolerable levels in 5/6 by day #1. Of the 4 cases with evaluable data on resumption of PO intake, time to resume PO ranged from 1-4 days.ConclusionCombination medical therapy may provide rapid improvement in symptoms associated with malignant bowel obstruction and dysfunction.© The Author(s) 2015.

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