Management of gastrointestinal symptoms in palliative care

2020 ◽  
Vol 13 (5) ◽  
pp. 273-279
Author(s):  
Monica Kumar
Keyword(s):  
Quality Of Life ◽  
Palliative Care ◽  
Systematic Approach ◽  
Clinical Symptoms ◽  
Gastrointestinal Symptoms ◽  
Health Needs ◽  
Team Approach ◽  
Advanced Malignancy ◽  
The Mind

The management of symptoms related to the gastrointestinal tract is an ongoing challenge in the care of patients with advanced malignancy. Clinical symptoms are often detrimental to a patient’s quality of life. The goal of palliative medicine includes care of the mind, body, and spirit. Symptom management and improving quality of life for patients and their families is paramount. As the population ages, this results in more complex health needs and the need for a multidisciplinary team approach. This article will outline a general and systematic approach to managing gastrointestinal symptoms in palliative care; it will emphasise the importance of holistic medicine in improving a patient’s quality of life.

scholarly journals Effectiveness of mebeverine in patients with post-cholecystectomy gastrointestinal spasm: results of prospective observational program “odyssey”

2018 ◽  
Vol 90 (8) ◽  
pp. 40-47 ◽  
Author(s):  
I V Maev ◽  
Yu A Kucheravy ◽  
V V Tsukanov ◽  
E Yu Eremnia ◽  
D N Andreev ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Abdominal Pain ◽  
Surgical Treatment ◽  
Rating Scale ◽  
Clinical Symptoms ◽  
Gastrointestinal Symptoms ◽  
Marked Change ◽  
Numeric Rating Scale ◽  
Observational Assessment

Aim: to assess the effectiveness of mebeverine 200 mg BID in patients with post-cholecystectomy gastrointestinal spasm not requiring surgical treatment. Materials and methods. 218 patients were included in 16 clinical centers in 14 cities in Russia. All patients had post-cholecystectomy gastrointestinal spasms, not requiring surgical treatment and received mebeverine (Duspatalin®) 200 mg BID. The observational assessment period lasted from the moment of their inclusion into the study up to 6 weeks post inlusion. The therapy results were evaluated using visual analog scales (GPA and 11-point numeric rating scale) by patient self-assessment of the dynamics of spasm/discomfort and other post-cholecystectomic gastrointestinal symptoms after 2 and 6 weeks of treatment. Gastrointestinal Quality of Life Index (GIQLI) was used to assess patient quality of life. Results and discussion. All 218 patients completed the 2-week mebeverine treatment course, 101 of them finished the 6-week course (“prolonged population”). Significant positive changes in the relief of abdominal pain and dyspepsia were noted as well as normalization of stool frequency and consistency. A more marked change in values was observed during prolonged (up to 6 weeks) therapy. Both 2-week and 6-week mebeverine courses led to a normalization of patient quality of life. After 6 week therapy, an effect of mebeverine on the quality of life 91% of patients was observed comparable to cholecystectomy itself, speficially related to the quality of life subscore ‘symptoms’. Conclusion. The results of our study demonstrate that mebeverine (Duspatalin®) therapy leads to an effective elimination of clinical symptoms associated with post-cholecystectomy GI-spasm disorders, like abdominal pain, symptoms of dyspepsia and stooldisorders. A more marked change in values was observed during prolonged (up to 6 weeks) therapy.

scholarly journals MODERN METHODS OF TREATMENT IN PALLIATIVE CARE

2019 ◽  
Vol 72 (7) ◽  
pp. 1229-1235
Author(s):  
Ewa Kucharska ◽  
Aleksandra Kucharska ◽  
Aleksander Sieroń ◽  
Mariusz Nowakowski ◽  
Karolina Sieroń
Keyword(s):  
Quality Of Life ◽  
Palliative Care ◽  
Hospice Care ◽  
Clinical Symptoms ◽  
Care Patient ◽  
Unique Type ◽  
Modern Methods ◽  
High Dynamics ◽  
Methods Of Treatment

The palliative care patient is definitely a unique type of patient. Due to the complexity of the symptoms requires a holistic therapeutic approach. Modern methods of treatment in palliative and hospice care underline an important role of physio, kinesiotherapy and pharmacological treatment coexistence. The rehabilitation reduces clinical symptoms, accompanying the basic disease and increases the quality of life of palliative patients and their families. It becomes an inseparable element of treatment, both in outpatient care as well as in stationary care and home care. Due to the high dynamics onset of cancer in the group of geriatric patients there is a need for a broader analysis of the topic. The goal of palliative care is to achieve the best possible quality of life for patients and their families.

Nausea and Vomiting

2018 ◽  
Author(s):  
Shalini Dalal
Keyword(s):  
Quality Of Life ◽  
Palliative Care ◽  
Gastrointestinal Symptoms ◽  
Specific Treatment ◽  
Intravenous Fluids ◽  
Cancer Treatments ◽  
Unpleasant Sensation ◽  
Common Causes ◽  
Food And Fluid Intake

Nausea is an unpleasant sensation of being about to vomit, can occur alone or can accompany vomiting, dyspepsia, or other gastrointestinal symptoms. It is common symptoms in patients receiving palliative care and is associated with substantial physical and psychological distress and worsening of quality of life. In cancer patients, cancer treatments and opioids are the most common causes. Management include supportive measures such as maintaining proper oral hygiene, frequent small volume food and fluid intake at regular intervals, intravenous fluids if appropriate, and discontinuation of unnecessary medications. Specific treatment should target the underlying cause, e.g., aggressive bowel regimen for opioid related constipation, and 5HT3 receptor antagonists for chemotherapy induced nausea.

Palliative care in old age

2001 ◽  
Vol 11 (2) ◽  
pp. 149-157 ◽  
Author(s):  
Raymond SK Lo ◽  
Jean Woo
Keyword(s):  
Quality Of Life ◽  
Palliative Care ◽  
Palliative Medicine ◽  
Holistic Approach ◽  
Physical Symptoms ◽  
World Health ◽  
Team Approach ◽  
Curative Therapy ◽  
Care And Support

What is palliative medicine?In 1987, the Royal College of Physicians recognized palliative medicine as a specialty, defining it as ‘the study and management of patients with far-advanced disease for whom the prognosis is limited and the focus of care is quality of life’. In 1990, the World Health Organization added its definition, ‘the active and total care of a person whose condition is not responsive to curative therapy’. The aim of palliative medicine is to control pain and other physical symptoms, together with integration of psychological, social, spiritual care and support. The ultimate goal is to help patients to achieve their best quality of life. Palliative medicine places emphasis on a holistic approach, offering care and support not just for patients but also for their families. Palliative medicine hence requires an interdisciplinary team approach. With the co-ordinated efforts of all disciplines (such as doctors, nurses, therapists, social workers, clinical psychologists, dieticians, pastoral care workers and volunteers), patients can be supported in living their remaining lives as actively as possible, and families can be assisted in coping with illness, death and bereavement. Palliative care neither intends to postpone death nor does so, but affirms life and regards dying as a normal process. When a patient faces an incurable illness, it is incumbent on the palliative care team to provide the best treatment and care, adding life to days when days cannot be added to life.

scholarly journals Radionuclide study in gastroparesis: Is it still relevant?

2016 ◽  
Vol 15 (1) ◽  
Author(s):  
Mohamad Shahrir Abdul Rahim ◽  
Ibrahim Lutfi bin Shuaib ◽  
Sazilah binti Ahmad Sarji
Keyword(s):  
Quality Of Life ◽  
Clinical Symptoms ◽  
Gastrointestinal Symptoms ◽  
Mechanical Obstruction ◽  
Radionuclide Scintigraphy ◽  
Radionuclide Study ◽  
Approaches To Study ◽  
High Index Of Suspicion

The incidence of gastroparesis in Malaysia is not well documented. Gastroparesis may present with various combinations of debilitating sign and symptoms that decrease quality of life and increases morbidity. It is diagnosed based on clinical symptoms and exclusion of the obstruction. There should be a high index of suspicion in patients who present with symptoms to avoid missing the diagnosis. There are various approaches to study the gastric motility. Here’s a case of a young adult woman with type 1 diabetes mellitus suffering severe gastrointestinal symptoms. In this case, radionuclide scintigraphy is used as one of the investigation to confirm the diagnosis of gastroparesis. Radionuclide scintigraphy remains a hallmark in the diagnosis of gastroparesis after excluding mechanical obstruction.

scholarly journals COVID-19 and influenza: main differences between clinical symptoms

2021 ◽  
Vol 2 (1) ◽  
pp. 25-32
Author(s):  
V.O. Boyko
Keyword(s):  
Quality Of Life ◽  
Differential Diagnosis ◽  
Exponential Growth ◽  
Clinical Symptoms ◽  
Clinical Course ◽  
Clinical Manifestations ◽  
Gastrointestinal Symptoms ◽  
Neurological Manifestations ◽  
Asymptomatic Carriage

This review analyzes the clinical symptoms, differential diagnosis of COVID-19 and influenza to facilitate clinical diagnosis of both diseases. The development of the COVID-19 epidemic occurred with an exponential growth of the incidence due to the high contagiousness of the virus, asymptomatic carriage. The situation was aggravated by the contagiousness of the patient in the last 2–3 days of the incubation period (before clinical manifestations), which made it difficult to isolate patients and contacts in a timely. The spectrum of damage to the organs and systems is constantly expanding with a more detailed study of the clinical course of COVID-19. Sometimes, the manifestations of COVID-19 persist even during the period of convalescence, which cause a decrease in the performance and quality of life of patients. The article discusses neurological manifestations, gastrointestinal symptoms and features of pneumonia in COVID-19. The clinical features of influenza and the main differences in the clinical course from COVID-19 are also demonstrated.

A retrospective analysis evaluating the benefit of early palliative care for patients with advanced pancreatic adenocarcinoma.

2014 ◽  
Vol 32 (31_suppl) ◽  
pp. 30-30
Author(s):  
Julia Quintin ◽  
Jaafar Bennouna ◽  
Hélène Senellart ◽  
Sandrine Hiret ◽  
Veronique Barbarot
Keyword(s):  
Quality Of Life ◽  
Pancreatic Cancer ◽  
Palliative Care ◽  
Overall Survival ◽  
Clinical Symptoms ◽  
Advanced Pancreatic Cancer ◽  
Group Versus ◽  
Care Group ◽  
Early Palliative Care

30 Background: Patients with advanced pancreatic carcinoma exhibit from the diagnosis and beyond severe clinical symptoms dominated by pain and weight loss, hampering quality of life. A recent study in metastatic lung cancer have shown a clear advantage of early palliative care in both quality of life and mood (Temel JS, et al. N Engl J Med 2010;363:733-42). Methods: Based on these data, we conducted a monocentric retrospective study including patients with advanced pancreatic cancer newly diagnosed and treated according with standard guidelines. The aim of this study was to determine the contribution of early palliative care visits (with supportive care physicians) on disease control symptoms, quality of life and overall survival. Results: From January 2006 to December 2010, 157 patients, PS 0, 1 or 2, with newly diagnosis of advanced pancreatic cancer were retrospectively enrolled. 126 patients (80.3 %) received at least one chemotherapy line. Out of 157 patients, 64 (40.7%) were seen in our palliative care department. Demographic patient characteristics between the two groups were well balanced; palliative care versus non palliative care: median age, 66.2 vs 66.7 years; PS 0,1 51 (79.5 %) vs 73 (79.7 %) ; male 34 (53.1 %) vs 47 (50.5 %) ; metastatic disease 39 (60.9%) vs 51 (54.8 %). Patients in the palliative care group showed more clinical symptoms at diagnosis, especially pain (73.4% patients in palliative care group versus 50.5%; p=0.004). They received less aggressive care at the end of their life: interruption of chemotherapy earlier (1.7 months before death versus 1.2 months) and less number of chemotherapy cycles in the month before death (22.7% versus 43.5%, p=0.042). However, no significant difference was observed for overall survival between both groups: 7.5 months in palliative care group versus 6.9 months (p=0.99). Conclusions: This study underlines the need of a multidisciplinary approach in advanced pancreatic cancer, promoting palliative care started initially at the diagnosis. It deserves to be completed by a largest prospective randomized study including a quality of life analysis.

scholarly journals Palliative care in pediatric patients with hematologic malignancies

Hematology ◽  
2015 ◽  
Vol 2015 (1) ◽  
pp. 490-495 ◽  
Author(s):  
Lisa Humphrey ◽  
Tammy I. Kang
Keyword(s):  
Quality Of Life ◽  
Palliative Care ◽  
Hospice Care ◽  
Hematologic Malignancies ◽  
Transitions Of Care ◽  
Institute Of Medicine ◽  
Healthcare Organizations ◽  
Advanced Illness ◽  
Advanced Malignancy

Abstract Children with advanced cancer, including those with hematologic malignancies, can benefit from interdisciplinary palliative care services. Palliative care includes management of distressing symptoms, attention to psychosocial and spiritual needs, and assistance with navigating complex medical decisions with the ultimate goal of maximizing the quality-of-life of the child and family. Palliative care is distinct from hospice care and can assist with the care of patients throughout the cancer continuum, irrespective of prognosis. While key healthcare organizations, including the Institute of Medicine, the American Academy of Pediatrics and the American Society of Clinical Oncology among many others endorse palliative care for children with advanced illness, barriers to integration of palliative care into cancer care still exist. Providing assistance with advance care planning, guiding patients and families through prognostic uncertainty, and managing transitions of care are also included in goals of palliative care involvement. For patients with advanced malignancy, legislation, included in the Patient Protection and Affordable Health Care Act allows patients and families more options as they make the difficult transition from disease directed therapy to care focused on comfort and quality-of-life.

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