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Oral water-soluble contrast for malignant bowel obstruction: open label pilot study
  1. Wan Fadzrul Izuan Bin Wan Bahrum1,2,
  2. Janet Hardy1,3,
  3. Karyn Foster1,3 and
  4. Phillip Good1,2,3
  1. 1 Palliative and Supportive Care, Mater Misericordiae Ltd, South Brisbane, Queensland, Australia
  2. 2 Department of Palliative Care, St Vincent's Private Hospital, Brisbane, Queensland, Australia
  3. 3 Mater Research - University of Queensland, South Brisbane, Queensland, Australia
  1. Correspondence to Karyn Foster, Palliative and Supportive Care, Mater Misericordiae Ltd, South Brisbane, Queensland, Australia; karyn.foster{at}mater.org.au

Abstract

Objectives Malignant bowel obstruction (MBO) is a common, challenging condition in advanced cancer. Oral water-soluble contrast medium (Gastrografin) has been used in the management of MBO without quality studies of its effectiveness and safety. The purpose of this study was to evaluate the feasibility, effectiveness and adverse effects of Gastrografin in patients with MBO and to assess feasibility of the study protocol.

Methods A prospective, interventional, single-arm, open label study of Gastrografin across two centres. Patients with unresolved inoperable MBO after 24 hours of conservative medical management were given a single dose of 100 mL of oral Gastrografin.

Results Over 33 months, 69 individual patients were screened. Of the 20 recruited, 17 completed study assessments (85%). MBO resolved in 10 of 17 patients (59%). Gastrografin passed through to the rectum in 14 patients (78%). The most common adverse effects were diarrhoea, vomiting, nausea and abdominal pain.

Conclusions Patient recruitment took longer than anticipated, but the study protocol is feasible. Gastrografin was found to be a relatively effective option for the treatment of MBO. An adeqautely powered randomised controlled trial is needed to formally assess the efficacy and safety of Gastrografin© in MBO.

  • supportive care
  • symptoms and symptom management
  • intestinal obstruction
  • other cancer

https://doi.org/10.1136/bmjspcare-2021-003444

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    Footnotes

    • Contributors JH, PG, KF have contributed to the concept and design of the study and acquisition of the data. WFIBWB and PG contributed to the analysis and interpretation of the results. All authors have contributed to the drafting, revision of content and authorised the final version of the paper.

    • Funding This study was funded in part by a seeding grant from the Mater Foundation.

    • Competing interests None declared.

    • Provenance and peer review Not commissioned; externally peer reviewed.

    • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.