In a pilot-study 25 patients presenting with a paralytic ileus due to diffuse intraabdominal metastases were treated with motilin. There were 16 male (64%) and nine female (36%) patients. Gastric cancer was the most frequent cause (40%), followed by pancreatic (36%), and colorectal (20%) cancer. 36% had received a postoperative chemotherapy before commencing the motilin-scheme. In 92% motilin therapy was started within 48 hours after the diagnosis of paralytic ileus. There were no serious side-effects of motilin therapy. In approximately 80% the pretherapeutic state was improved. Thus, it seems worthwhile to investigate the influence of motilin on paralytic ileus in incurable cancer patients in a prospective controlled trial.