Malignant Bowel Obstruction; when the surgery is not an option

Intestinal obstruction (IO) is not unusual in patients with a diagnosis of cancer, especially ovarian cancer and colorectal cancer. The physiological and pathological basis of obstruction or apparent obstruction of the alimentary tract is complex. Surgical option (including stents, or venting gastrectomy) should be considered, usually directly by or with a gynecological oncologist or surgeon. Colostomy should always be carefully considered in patient with lower colonic obstruction as it can prevent some of the most distressing symptoms. If surgery is not to be undertaken, there are useful medical measures to be applied to relieve symptoms fairly well. What is the role of chemotherapy in MBO Is there any place for Total Parenteral Nutrition in patients with metastatic, incurable disease What are new pharmacological treatments of MBO How long will a patient live with medical management of end-stage intestinal obstruction It is ethical to let the patient die of electrolyte imbalance – do not measure electrolytes This study is the result of following up ten patients with MBO due to advanced ovarian cancer who have referred to palliative edicine clinic. Conclusion: MBO is a complex clinical situation that requires a multidisciplinary approach to ensure the appropriate treatment modality and interprofessional care to optimally manage these patients. In advanced cancer when the surgery is not feasible, palliative care would be the best option for symptom management and improving quality of life of patients.