Altered bowel function

2019 ◽  
pp. 501-512
Keyword(s):  
Cancer Patients ◽  
Bowel Obstruction ◽  
Medical Management ◽  
Early Identification ◽  
Bowel Function ◽  
Cancer Drug ◽  
Dietary Advice ◽  
Management Options ◽  
Pharmacological Management ◽  
Associated Symptoms

This chapter explores the three most common bowel-related issues that cancer patients often face: diarrhoea, constipation, and bowel obstruction. Cancer-related causes of diarrhoea are discussed, including new cancer drug therapies. Assessment and management of diarrhoea are explored in detail, with a focus on reversible causes and pharmacological and non-pharmacological management. Constipation is explored in similar detail. Management includes dietary advice, use of laxatives, and non-pharmacological measures. Bowel obstruction is discussed, focusing on early identification of symptoms and a look at both surgical and medical management options, including management of associated symptoms.

Safety and Efficacy of Venting Gastrostomy in Malignant Bowel Obstruction: A Systematic Review

2019 ◽  
Vol 35 (2) ◽  
pp. 93-102 ◽  
Author(s):  
Sreeharshan Thampy ◽  
Pavan Najran ◽  
Damian Mullan ◽  
Hans-Ulrich Laasch
Keyword(s):  
Systematic Review ◽  
Bowel Obstruction ◽  
Medical Management ◽  
Symptom Control ◽  
Complication Rates ◽  
Malignant Bowel Obstruction ◽  
Management Options ◽  
Safety And Efficacy ◽  
Nonsurgical Management ◽  
Abdominal Malignancy

Malignant bowel obstruction (MBO) is a common manifestation in patients with advanced intra-abdominal malignancy. It is especially common with bowel or gynecological cancers and produces distressing symptoms, including nausea, vomiting, and pain. Medical management options are less effective than decompressive strategies for symptom control. Surgery is the gold-standard treatment but is unsuitable for most patients with high complication rates. Consensus guidelines recommend nonsurgical management with a venting gastrostomy in those unsuitable for surgery or for whom medical management is ineffective. The aim of this systematic review is to establish the safety and efficacy of percutaneous venting gastrostomy in relieving symptoms of MBO. Twenty-five studies were included in this review comprising 1194 patients. Gastrostomy insertion was successful at first attempt in 91% of cases and reduction in symptoms of nausea and vomiting was reported in 92% of cases. Mean survival following the procedure ranged from 35 to 147 days. Major complications were rare, with most complications classed as minor wound infections or leakage of fluid around the tube. Studies suggest that the presence of ascites is not an absolute contraindication to the insertion of percutaneous venting gastrostomy in patients with MBO; however, these studies lack longitudinal outcomes and complication rates related to this. However, it is reasonable to suggest that ascitic drainage is performed to reduce potential complications. There is a relative lack of good quality robust data on the utilization of percutaneous venting gastrostomy in MBO, but overall, the combination of being a safe and efficacious procedure alongside the known complication profile suggests that it should be considered a suitable management option.

Preventing Premature Weaning: Management Options for Common Lactation Conditions, Including OMT

2020 ◽  
pp. 20-25
Author(s):  
Denise Sackett ◽  
Tala Dajani ◽  
David Shoup ◽  
Uzoma Ikonne
Keyword(s):  
Postpartum Depression ◽  
Family Physician ◽  
Treatment Options ◽  
World Health ◽  
Management Options ◽  
Pharmacological Management ◽  
Control And Prevention ◽  
Lactational Mastitis ◽  
One Year ◽  
Health Organization

The benefits of breastfeeding are well established. The World Health Organization and the Centers for Disease Control and Prevention recommend that mothers breastfeed infants for at least one year, but most children are not breastfed that long because of many factors. Breastfeeding mothers face many challenges to continued breastfeeding, including medical conditions that arise during this period, such as postpartum depression and lactational mastitis. Because of a perceived lack of consistent guidance on medication safety, it can be difficult for the family physician to treat these conditions while encouraging mothers to continue breastfeeding. The purpose of the current review is to summarize and clarify treatment options for the osteopathic family physician treating lactating mothers. We specifically focus on the pharmacological management of contraception, postpartum depression, and lactational mastitis.

Pegfilgrastim-Induced Bone Pain: A Review on Incidence, Risk Factors, and Evidence-Based Management

2017 ◽  
Vol 51 (9) ◽  
pp. 797-803 ◽  
Author(s):  
Donald C. Moore ◽  
Annie E. Pellegrino
Keyword(s):  
Risk Factors ◽  
Bone Pain ◽  
English Language ◽  
Data Extraction ◽  
Treatment Modalities ◽  
Management Options ◽  
Data Synthesis ◽  
Pharmacological Management ◽  
Study Selection ◽  
Incidence Risk

Objective: To review the incidence, risk factors, and management of pegfilgrastim-induced bone pain (PIBP). Data Sources: PubMed was searched from 1980 to March 31, 2017, using the terms pegfilgrastim and bone pain. Study Selection and Data Extraction: English-language, human studies and reviews assessing the incidence, risk factors, and management of PIBP were incorporated. Data Synthesis: A total of 3 randomized, prospective studies and 2 retrospective studies evaluated pharmacological management of PIBP. Naproxen compared with placebo demonstrated a reduction in the degree, incidence, and duration of bone pain secondary to pegfilgrastim. Loratadine was not effective in reducing the incidence of bone pain prophylactically, but a retrospective study evaluating dual antihistamine blockade with loratadine and famotidine demonstrated a decreased incidence in bone pain when administered before pegfilgrastim. Conclusion: Naproxen is effective at managing PIBP. Although commonly used, antihistamines have a paucity of data supporting their use. Dose reductions of pegfilgrastim and opioids may also be potential management options; however, data supporting these treatment modalities are scarce.

Tu1689 - Long-Term Outcomes of Colorectal Cancer Patients with and without Malignant Large-Bowel Obstruction

2018 ◽  
Vol 154 (6) ◽  
pp. S-1352
Author(s):  
Riku Yamamoto ◽  
Shinya Munakata ◽  
Tomoyuki Kushida ◽  
Hajime Orita ◽  
Mutsumi Sakurada ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Cancer Patients ◽  
Bowel Obstruction ◽  
Large Bowel ◽  
Large Bowel Obstruction ◽  
Long Term Outcomes ◽  
Colorectal Cancer Patients

scholarly journals P-50 Hypercalcaemia of malignancy: an analysis of the medical management of palliative cancer patients in community, hospice and hospital settings

2017 ◽  
Vol 7 (Suppl 1) ◽  
pp. A18.2-A19
Author(s):  
Claire McKenzie ◽  
Rachel McDonald ◽  
Amara Nwosu ◽  
Alison White ◽  
Jenny Smith ◽  
...  
Keyword(s):  
Cancer Patients ◽  
Medical Management

scholarly journals TCT-609 Choosing Between Transcatheter, Surgical, and Medical Management in Cancer Patients With Severe Aortic Stenosis

2018 ◽  
Vol 72 (13) ◽  
pp. B244
Author(s):  
Dinu Balanescu ◽  
Teodora Donisan ◽  
Michael Schechter ◽  
Tariq Dayah ◽  
Daryl Sudasena ◽  
...  
Keyword(s):  
Aortic Stenosis ◽  
Cancer Patients ◽  
Medical Management ◽  
Severe Aortic Stenosis

scholarly journals Management of tubal ectopic pregnancy with methotrexate in the setting of symptomatic Coronavirus disease 2019 (COVID-19): A case report

2021 ◽  
Vol 13 (3) ◽  
pp. 277-281
Author(s):  
N.M. Millan ◽  
J Morano ◽  
L Florez ◽  
J Carugno ◽  
C.A. Medina
Keyword(s):  
Case Report ◽  
Literature Review ◽  
Supportive Care ◽  
Medical Management ◽  
Patient Management ◽  
Therapeutic Option ◽  
Careful Consideration ◽  
Management Options ◽  
Tubal Ectopic Pregnancy ◽  
Ectopic Pregnancies

Background: Coronavirus Disease 2019 (COVID-19) represents a complex therapeutic challenge. As the pandemic progresses, patients are presenting with ectopic pregnancies (EPs) and symptomatic COVID-19. Objective: We present the management of a patient with multiple medical comorbidities and tubal EP in the setting of severe symptomatic COVID-19 infection where all management options were precluded. Methods: Case report with literature review of management of tubal EP in the setting of severe symptomatic COVID-19 infection. Result: After careful consideration of options, the patient underwent successful medical management with methotrexate while receiving supportive care for COVID-19. Conclusions: Methotrexate proved to be the safest therapeutic option in this patient. Management of patients with severe COVID-19 and gynaecologic emergencies should be individualised and carefully reviewed with evolving knowledge of COVID-19.

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