Bowel Obstructions in Patients with Peritoneal Mesothelioma

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.