Question:

Drug wipes out life-threatening bowel obstruction

Marcia –     Thanks for this information.  I hadn’t seen this before, and this information will likely be helpful to at least some of us (unfortunately).  The entire text of the article – not just the abstract –  is available at: http://www.nejm.org/content/ponec/1.asp                                                 Thanks,                                                 MartyBL

Response:

I found this article on bowel obstructions on the cnn.com site this morning. Maybe it can be of some help. Drug wipes out life-threatening bowel obstruction May 26, 1999 Web posted at: 11:33 AM EDT (1533 GMT) BOSTON (Reuters) — A muscle-reactivating drug already in use can eliminate potentially fatal bowel blockages that sometimes appear after surgery, according to findings released seven weeks early because of their importance. The University of Washington research found that the drug neostigmine was effective in eliminating bowel blockages. The results are due to be published in the July edition of the New England Journal of Medicine, but editors released the information Tuesday because of the potential to save lives. Neostigmine, sold by various manufacturers, costs about $3 a dose. Hospitals already use the drug to reverse some of the muscle-paralyzing effects of other drugs used in anesthesia. Researchers, led by Dr. Michael Kimmey, wanted to see if neostigmine would reactivate the muscles that propel waste through the bowels. Those muscles can shut down and cause a blockage in patients who are hospitalized after surgery, affected by severe illness or taking narcotic pain relievers. As wastes accumulate, the bowel begins to expand. It can become so enlarged it ruptures or cuts off the flow of blood to the rest of the bowel. When it ruptures — which happens in 3 percent of the cases — it spills feces into the abdomen, killing half the patients. The Kimmey team found that neostigmine removed the obstruction in 10 out of 11 patients who received it. When the 11th patient received a second dose, it worked. None of the 10 patients who received a saltwater placebo improved. Seven of those 10 were subsequently given neostigmine, and their obstructions cleared. The drug usually began to work in four minutes. Its side effects included abdominal pain and excessive salivation. In two patients, the heart rate became abnormally slow. Until now the blockage, known as acute colonic pseudo-obstruction, has been treated by withholding fluids, giving intravenous fluids or eliminating drugs that can slow the movement of waste through the bowel. When that fails, doctors must resort to an emergency colonoscopy or surgery. The work confirmed earlier uncontrolled studies showing that neostigmine is effective. http://www.cnn.com/HEALTH/9905/26/health.bowels.reut/index.html Marcia

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