What is the Evidence for the Pharmacological Management of Nausea and Vomiting in Inoperable Malignant Bowel Obstruction?

  • Ellen Barnes School of Medicine, Trinity College, University of Dublin, Ireland
  • Eoghan Blount School of Medicine, Trinity College, University of Dublin, Ireland
  • Katie Buckley School of Medicine, Trinity College, University of Dublin, Ireland
  • Ellen Carter School of Medicine, Trinity College, University of Dublin, Ireland
  • Liam Dwyer School of Medicine, Trinity College, University of Dublin, Ireland
  • Emily Loughman School of Medicine, Trinity College, University of Dublin, Ireland
  • Helena Myles School of Medicine, Trinity College, University of Dublin, Ireland; Our Lady’s Hospice, Harold’s Cross, Dublin, Ireland

Abstract

The objective is to systematically review the evidence available for the pharmacological management of nausea and vomiting in inoperable malignant bowel obstruction. PubMed, EMBASE and clinicaltrials.gov were searched using the following terms: Nausea, Vomiting, Cancer, Inoperable Bowel Obstruction, Malignant Bowel Obstruction. The search identified 699 studies and 1 from an additional source. With the inclusion and exclusion criteria applied 12 papers were selected. Of the 12 studies, 6 RCTs were identified that compared the somatostatin analogue octreotide or lanreotide. Two of these RCTs also compared octreotide to hyoscine butylbromide, and four with placebo. Octreotide was shown to significantly reduce nausea and vomiting. One study however, found that octreotide did not significantly reduce vomiting compared to a placebo. Prospective studies, retrospective studies and non-randomised clinical trials were also identified. They assessed the use of octreotide, granisetron or olanzapine. They found that there was significant improvement in nausea or vomiting episodes. Despite not being the first line treatment Octreotide appears to be the most studied and researched drug. In all but one study it has been found to have a positive outcome. This review has highlighted the lack of information or research available on other antiemetic or anti-nausea medications, despite their widespread use.

Published
2020-11-04
How to Cite
Barnes, E., Blount, E., Buckley, K., Carter, E., Dwyer, L., Loughman, E., & Myles, H. (2020). What is the Evidence for the Pharmacological Management of Nausea and Vomiting in Inoperable Malignant Bowel Obstruction?. Trinity Student Medical Journal , 20(1), Page 35-40. Retrieved from https://www.tsmj.ie/index.php/tsmj/article/view/1553