Bowel Obstructions in Patients with Peritoneal Mesothelioma

Mary Hesdorffer, NP

Mary Hesdorffer, NPPatients with peritoneal mesothelioma appear to be at an increased risk of bowel obstructions either due to disease or perhaps as a consequence of their treatment. They can be caused by adhesions (scar tissue) and/or tumors among other predisposing conditions. Signs of a bowel obstruction include abdominal pain, cessation of bowel movement, absence of bowel sounds and inability to digest food.  Patients might also vomit fecal material.

Bowel obstructions are considered to be a medical emergency and require immediate attention. However, not all obstructions require surgery. Patients are often admitted to the hospital where they receive IV hydration. A nasal gastric tube is placed to remove stomach contents thus permitting the bowel to rest and inflammation to resolve on its own. Symptoms usually resolve 3-5 days following this intervention. In some cases it may be necessary to perform a surgical procedure to remove the mass or adhesion thus freeing the bowel to receive the necessary blood supply to remain healthy and functional. Patients with symptoms consistent with a bowel obstruction should contact their medical team immediately.

If a bowel obstruction is suspected, the patient will undergo a series of abdominal X-rays which can help diagnose an obstruction and determine if it is located in the large or small intestine.

Some symptoms of obstruction may lead to the diagnosis of an ileus, which is a functional obstruction caused by the absence of peristalsis, without a true blockage. It can be the result of narcotics or side-effect of some chemotherapeutic drugs or other administered medications. Sometimes medication to increase gastric motility can help in reversing this condition and surgery is usually not indicated in this situation. Patients are often discharged from the hospital with instructions to continue with regimens that will help to produce increased bowel evacuation.

For questions about treatment options, clinical trials, side-effect, or general support, patients are encouraged to contact Mary Hesdorffer, Nurse Practitioner. Ms. Hesdorffer is the executive director of the Mesothelioma Applied Research Foundation. She received her undergraduate degree at the College of New Rochelle in NY and went on to receive her Masters of Science at the same institution. She is fully credentialed as a nurse practitioner and has spent 16 years actively treating patients with mesothelioma.

Mary has an expertise in the development and implementation of clinical trials. She is published in peer-reviewed journals and has lectured nationally on topics pertaining to mesothelioma with particular emphasis on clinical trials as well as symptom and disease management.

Mary is a strong voice in urging increased transparency to the medical and legal issues surrounding mesothelioma with a strong emphasis on ethics.

She is passionate in her commitment to the treatment and management of this disease and hopes to increase awareness of the need to advance the science that will lead to a cure. She is available via phone or email to assist patients and caregivers as they regain control after being thrust into the chaos of this disease.

1 Comment on "Bowel Obstructions in Patients with Peritoneal Mesothelioma"

  1. My nephew Nadeem Rajah was diagnosed with peritoneal mesothelioma on 18 June 2015 and sadly passed away 5 months later on 21 November 2015. He was 25 years old.
    3 days before he passed away he was admitted into hospital for bowel obstruction. The surgeons informed us that the bowel was obstructed in too many places therefore surgery was not an option. He was put on a nasal gastric tube in the hopes that the problem would rectify itself. The anger and bitterness that I feel is so overwhelming at times because it just doesn’t make sense that someone as young and healthy as him could be taken so abruptly by this awful disease. There are so many unanswered questions. The main one being how does someone who is 25 years old and has never, to anyones knowledge been exposed to asbestos, be diagnosed with stage 4 peritoneal mesothelioma?
    He had 2 treatments of Keytruda and his oncologist had a PET scan done and even though you don’t see results until after 4 to 5 treatments, his scan showed that the cancer hadnt spread and the scan wasn’t as “lit up” as the previous one. So it looked as if the Keytruda was working. But his body just shut down. The day before he passed away his sugar had dropped to below 2. His doctors managed to reverse that problem but he just stopped breathing 24 hours later! Did he lose his battle to cancer or was it due to the bowel obstructions?
    How does this happen to a 25 year old who never smoked or had any substance abuse history? Why is the treatment for Peritoneal mesothelioma so limited? Why are there stories published of people much older than him who have had some success with their treatment but a healthy 25 year old lose his battle so quickly. From the very beggining of his diagnose it was as if he never stood a chance. How ironic that the day before he dies he is given some positive news….. The Keytruda seems to be working. Was it too little too late?

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