Bowel obstruction is often due to multifactorial causes. Inflammatory oedema, faecal impaction, and constipation are likely causes. Bowel obstruction can be partial or complete, single or multiple, and due to benign or malignant causes.

Pancreatic cancer spreads directly to the duodenum or stomach, cancer of the colon spreads to the jejunum and ileum, prostate and bladder cancers spread to the rectum.

Bowel obstruction is a common and distressing outcome in patients with abdominal or pelvic cancer. Patients may develop bowel obstruction anytime in their disease progression. The prevalence range from 5.5% to 42% with ovarian cancer and from 10% to 28% with colorectal cancer. The causes of the obstruction may be benign post-operative adhesions, a focal malignant or benign deposit or relapse or diffuse carcinomatosis. The symptoms which are almost always present are intestinal colic, continuous abdominal pain, nausea and vomiting. Surgery is the primary treatment. However, some patients are unfit for surgery.  For these patients the options are:

1. use of nasogastric tube

2. percutaneous gastrostomy

3. pharmacological approach

The treatment options for bowel obstruction in advanced and terminal patients is still a widely debated topic in clinical medicine. Medical treatment by continuous subcutaneous or intravenous administration of opioids, corticosteroids, anti-cholinergic, octreotide, and anti-emetic drugs were shown to be effective in controlling pain, nausea and vomiting in patients with inoperable bowel obstruction. Nasogastric suction or percutaneous gastrostomy may be considered for patients with refractory symptoms  upper bowel obstruction which does not respond to pharmacological treatment.