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Malignant Bowel Obstruction — SCE Medical Oncology MCQ

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HardSupportive & Palliative OncologyMalignant Bowel ObstructionSCE Medical Oncology

A patient with inoperable malignant bowel obstruction is receiving continuous subcutaneous hyoscine butylbromide plus an antiemetic. Colic is controlled but high-volume vomiting persists after 24 hours. Which antisecretory escalation is recommended?

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Correct answer: B — Replace or escalate the antisecretory strategy to octreotide

NICE advises hyoscine butylbromide first and octreotide when obstructive vomiting has not improved within 24 hours. Laxatives and loperamide can worsen complete obstruction, parenteral nutrition is not an acute antiemetic, and surgery depends on anatomy and fitness rather than vomiting alone.

Reference: NICE NG31: care of dying adults. https://www.nice.org.uk/guidance/ng31/chapter/Recommendations