Management of intestinal obstruction in malignant disease.

Malignancy may present with intestinal obstruction or it may develop during the course of the disease. Obstruction is any process that prevents the movement of bowel contents distally. The lumen of the bowel may become occluded or there may be a decrease in normal bowel motility preventing normal propulsion of bowel contents along the gastrointestinal (GI) tract. It occurs in approximately 3% of all cancer patients, but in 16% of those with colon cancer and up to 42% of women with ovarian cancer.1–3 Any site along the GI tract can be affected. For those unsuitable for surgery, the traditional ‘drip and suck’ (intravenous hydration and nasogastric suction) will usually fail to control symptoms.4,5 Medical management will keep most of them free from nausea and pain, allowing them to be managed at home if they wish.4,6,7