Role of Steroids in Malignant Bowel Obstruction

Anuradha Patel and Rakesh Garg*

Role of Steroids in Malignant Bowel Obstruction.

Various cancers such as ovarian, stomach, colon or pancreas may present with mechanical bowel obstruction. This may be partial or total depending on the pathology and extent of the disease.

On presentation, the patient requires appropriate assessment and management as per underlying pathology and assessment findings.

Comprehensive medical and surgical management strategies are required to manage malignant bowel obstruction effectively. Steroids have been reported for their beneficial use in malignant bowel obstruction.

We review the usefulness of steroids in patients presenting with malignant bowel obstruction.

Bowel obstruction refers to functional or mechanical obstruction of the intestine which prevents physiological passage of food through the bowel.

The bowel obstruction may be partial or complete and depends on the underlying pathology and extent of the disease. If such obstruction occurs due to malignancy, it is referred as malignant bowel obstruction.

It can occur from an intraabdominal malignancy or related to malignancy with peritoneal involvement. The global prevalence of MBO is 3-15% of cancer patients.

MBO occurs more commonly in women, and the age at presentation ranges from 58-65 years. The time to manifestation of MBO from diagnosis of cancer is around 14 months.

The MBO occurs most commonly in the small bowel followed by the large bowel but may occur in both the small and large bowel simultaneously in 20% of patients.

Also, metastatic peritoneal deposits from breast cancer and melanoma lead to MBO in around 2-3%
respectively. The operative mortality and complication rates are very high with overall survival from 3-6 months.

Palliat Med Hosp Care Open J. 2016; 2(2): 30-36. doi: 10.17140/PMHCOJ-2-116