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Palliative cancer care - pain - Management
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How should I manage intestinal colic?
- Consider whether there is a treatable underlying cause:
- It may be possible to treat certain causes of colicky pain (for example, bowel colic due to constipation) in primary care — see the CKS topic on Palliative cancer care - constipation.
- However, some causes (for example, bowel obstruction) need specialist management and possibly surgical intervention, provided the person is fit enough for surgery and wants to be admitted.
- If symptomatic management is appropriate, consider hyoscine butylbromide (an antispasmodic).
- There is no agreement among experts in terms of dose or route of administration. Suggested doses are:
- 10–20 mg as a subcutaneous dose as required, repeated 2-hourly, or
- 40–300 mg as a subcutaneous infusion over 24 hours via a syringe driver.
- If the oral route is preferred, consider mebeverine 135 mg three times a day.
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