Kinesio-Taping vs. Usual Care for Malignant Bowel Obstruction With Ascites

Malignant bowel obstruction (MBO) with ascites is a common and severe complication among patients with advanced intra-abdominal or retroperitoneal malignancies. Standard management of MBO includes surgery, medical therapy (such as antiemetics, corticosteroids, or octreotide), and decompression using nasogastric tubes. However, many patients continue to experience distressing symptoms-such as persistent abdominal pain, nausea, vomiting, and bloating-despite aggressive treatment. These symptoms contribute to significant discomfort, reduced quality of life, and poor prognosis in patients with advanced cancer.

Kinesio-taping is an elastic, waterproof adhesive strip designed to mimic the properties of skin and soft tissue. It is widely used in rehabilitation and sports medicine for its potential to reduce pain, improve circulation, and provide mechanical support. The mechanism is thought to involve stimulation of cutaneous mechanoreceptors, improved lymphatic drainage, and modulation of muscle activity. While Kinesio-taping has shown benefits in managing lymphedema and musculoskeletal pain, its application in patients with MBO and ascites is not well-studied. Existing evidence is mostly limited to case reports and studies in other patient populations.

This randomized controlled trial aims to evaluate whether abdominal Kinesio-taping, in addition to standard care, can safely and effectively reduce symptom burden in adult cancer patients with MBO and ascites whose symptoms persist after conventional treatment. The trial is conducted at a single tertiary medical center. Eligible patients are randomized in a 1:1 ratio to either the intervention group (standard care plus Kinesio-taping) or the control group (standard care alone). The Kinesio-taping protocol uses an FDA-approved medical-grade tape (NKH-50R) and follows a standardized application technique. Prior to the first application, all patients in the intervention group undergo a skin sensitivity test. The tape is applied in a circular pattern around the umbilicus, with specific attention to avoiding tumor sites and open wounds, and removed using techniques designed to minimize skin trauma.

All participants continue to receive standard care for MBO, including pain management, fluid and electrolyte support, and palliative interventions as appropriate. Data are collected at baseline and three days after intervention. The primary outcome is change in symptom severity, measured by the Edmonton Symptom Assessment System modified for ascites (ESAS:AM). Secondary outcomes include changes in abdominal girth and dosage of analgesic medications. Safety is monitored through daily assessment for skin reactions or other adverse effects.

This study is designed with rigorous attention to ethical conduct and data privacy. All participant information is de-identified and securely stored, and only authorized research personnel have access. The anticipated sample size is 40 participants, with randomization stratified by baseline symptom severity to ensure balanced allocation. Data will be analyzed using appropriate statistical methods, including independent t-tests and generalized estimating equations for repeated measures.

If proven effective and safe, Kinesio-taping could offer a non-invasive, low-cost, and easily administered adjunct to standard palliative care for patients with malignant bowel obstruction and ascites, potentially empowering both patients and caregivers with a new option for symptom relief.

Inclusion criteria

• Adults aged 18 years or older.
• Histologically confirmed intra-abdominal or retroperitoneal malignancy.
• Diagnosis of malignant bowel obstruction with ascites located below the ligament of Treitz.
• Persistent severe symptoms (such as pain, bloating, nausea, vomiting) after surgery, medication, or nasogastric tube treatment.
• Able to communicate in Mandarin or Taiwanese.
• Capable of providing informed consent.

Exclusion criteria

• Presence of significant abdominal wounds that preclude application of Kinesio tape.
• Known allergy or hypersensitivity to Kinesio tape.
• Pregnancy.
• Lack of decision-making capacity.