Oral Water Soluble Contrast compared with Placebo for Malignant Bowel Obstruction

Patient or population: Adults 18 yrs and over with malignant bowel obstruction (MBO) as defined by the International Conference on MBO, with no indication for other treatments e.g. surgery, endoscopy, etc

Settings: Hospital inpatients

Intervention: 100 mL of gastrografin administered orally

Comparison: Placebo (100m L of distilled water flavoured with aniseed oil in order to mimic the taste and smell of gastrografin)

1. The ability of OWSC, when seen to reach the colon on follow‐up imaging, to predict the likelihood of malignant small bowel obstruction resolving with conservative treatment alone (diagnostic).

no data

2. The rate of resolution of MBO with medical management only in patients receiving OWSC compared with those not receiving it (therapeutic).

no data

3. Gastrointestinal adverse effects (increased abdominal pain, nausea, vomiting).

Although they reported that "no issues regarding safety or tolerability of either gastrografin or placebo were identified", no data were actually reported.

4. Extra‐abdominal complications (aspiration pneumonia, hypersensitivity reactions).

Although they reported that "no issues regarding safety or tolerability of either gastrografin or placebo were identified", no data were actually reported.

5. Length of hospital stay.

no data

6. Time from administration of OWSC to resolution of MBO.

no data

7. Survival time from onset of inoperable MBO until death.

no data

GRADE Working Group grades of evidence
High quality: we are very confident that the true effect lies close to that of the estimate of the effect;
Moderate quality: we are moderately confident in the effect estimate; the true effect is likely to be close to the estimate of effect, but there is a possibility that it is substantially different;
Low quality: our confidence in the effect estimate is limited; the true effect may be substantially different from the estimate of the effect;
Very low quality: we have very little confidence in the effect estimate; the true effect is likely to be substantially different from the estimate of effect.