Bowel obstruction in palliative care is due to a partial or complete occlusion of the bowel lumen, preventing or delaying the movement of intestinal contents. This can have an acute or sub-acute onset. Causes may include abdominal malignancy, intra-abdominal carcinomatosis, post-surgical adhesions, and intestinal motility disorders. Faecal impaction can result in similar symptoms and should be excluded.
Active treatment of bowel obstruction can include medical or surgical options depending on the patient’s clinical condition, their disease status, co-morbidities and function. Some patients may benefit from surgical intervention, for example if their bowel obstruction is localised and they are well enough to benefit from surgery. Consult or refer to specialist palliative care services as required.
This website describes the clinical evidence supporting management of bowel obstruction in palliative care.
Bowel care and intestinal obstruction in end of life care
The Palliative Care Bridge
This interview with Dr Bridget Johnson provides an overview of the causes and management of constipation and bowel obstruction and the importance of differentiating between the two.