ABSTRACT
Bowel obstruction is defined as any process preventing the movement of bowel contents. Malignant bowel obstruction (MBO) is defined using the following criteria: clinical evidence of bowel obstruction beyond the ligament of Treitz, in the setting of a diagnosis of intra-abdominal cancer with incurable disease or a diagnosis of non-intra-abdominal primary cancer with clear intraperitoneal disease. The small bowel is more commonly involved than the large bowel and both are involved in over 20% of the patients. Gastrointestinal symptoms caused by the sequence of distension–secretion–motor activity of the obstructed bowel occur in different combinations and intensity depending on the site of obstruction and tend to worsen. Malignant large-bowel obstruction can be managed by sigmoidoscopy, colonoscopy, or transanal wire-guided approaches under fluoroscopy alone. The pharmacological management of bowel obstruction due to advanced cancer focuses on the treatment of nausea, vomiting, pain, and other symptoms without the use of a nasogastric tube.
