[Nutritional and digestive disorders in palliative care].
The anorexia-cachexia syndrome is a particularly frequent complication of advanced cancer. Parenteral nutrition must remain the exception in palliative medicine but enteral nutrition through feeding tubes or by a gastrostomy is an efficient method to provide an adequate long term nutritional support at home which can improve the quality of life of the palliative care patient. One must never forget all simple means to improve nutritional status. Since the cost benefit ratio of the medications stimulating the appetite, such as the corticosteroids and the progestatives, must still be demonstrated in palliative medicine. Hiccups therapy is essentially based on several non pharmacological means and on the administration of metoclopramide, antacids, haloperidol or chlorpromazine. Chronic nausea is an extremely frequent problem in palliative care, treated most often by metoclopramide, haloperidol and corticosteroids. Constipation is another extremely frequent problem which can lead to serious complication if left untreated. Besides general means, therapeutic means essentially comprise drugs such as lactulose and macrogol, bisacodyl, docusan and prokinetic agents like cipraside.
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Clinique des Soins Supportifs et Palliatifs, Institut Jules Bordet, U.L.B.
Mancini
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D005767:Gastrointestinal Diseases / Q000209:etiology* / Q000628:therapy*; D006801:Humans; D009369:Neoplasms / Q000150:complications*; D009748:Nutrition Disorders / Q000209:etiology* / Q000628:therapy*; D018529:Nutritional Support / Q000379:methods*; D013727:Terminal Care / Q000379:methods*