Clearing bowel obstruction and decreasing pain in a terminally ill patient via manual physical therapy.

Decreasing pain and improving function and quality of life are important topics for patients that refuse, or are not candidates for traditional medical interventions, and those at end stages of disease. Patients with inoperable, metastatic bowel carcinoma that experience pain and small bowel obstruction (SBO) as a result of adhesions are a subset of these patients. The standard treatment, adhesion and/or resection surgery followed by post-surgical medications to prevent infection and decrease pain, may not be ideal in end-stage cancer patients. We treated such a patient using a manual soft tissue physical therapy with goals of decreasing her pain and alleviating symptoms of bowel obstruction secondary to adhesions successfully, using a protocol we developed initially to open fallopian tubes that were blocked by adhesions.