The role of somatostatin and octreotide in bowel obstruction: Pre-clinicaland clinical results

Malignant bowel obstruction is a common complication in patients with advan ced abdominal or pelvic cancer. Whereas surgery should be considered in all cases of malignant bower obstruction, many advanced and terminal cancer pa tients are considered unfit for surgery. In such patients with a short life expectancy, gastrointestinal symptoms such as nausea, vomiting, continuous and/or colicky pain, can be controlled by using a pharmacologic approach m ade up of analgesics, antiemetics and antisecretory drugs, without the use of a venting nasogastric tube. Among the antisecretory drugs, octreotide ha s been shown to reduce nausea and vomiting in bower-obstructed patients owi ng to a reduction of gastrointestinal secretions, thus allowing in most pat ients removal of the nasogastric tube and the associated distress. Preclini cal and clinical studies that demonstrated the role of somatostatin and oct reotide in bowel obstruction are reviewed.