Managing nonmalignant chronic abdominal pain and malignant bowel obstruction.
Evaluation of abdominal pain requires an understanding of the possible causes(benign or malignant) and recognition of typical patterns and clinical presentation. Abdominal pain has multiple causes; associated signs and symptoms may aid in the diagnosis. Remember that some patients will not have a textbook presentation, and unusual causes for pain must be considered. Those with chronic pancreatitis with structural complications should be operated on early, whereas those with other types of chronic pancreatitis should receive medical therapy focusing on alleviating symptoms. Control of the most troublesome symptoms will provide the best management for IBS. Pharmacologic success in bowel obstruction depends on the level and degree of obstruction. Decision making is based on reasonable expectations of survival, treatment-related success, performance status, and goals of care. Quality of life will be enhanced by appropriate symptom management.
Bicanovsky
Lesley K
LK
The Harry R. Horvitz Center for Palliative Medicine, Taussig Cancer Center, Cleveland Clinic, 9500 Euclid Avenue, M76, OH 44195, USA.
Lagman
Ruth L
RL
Davis
Mellar P
MP
Walsh
Declan
D
D015746:Abdominal Pain / Q000209:etiology / Q000628:therapy*; D002908:Chronic Disease; D006801:Humans; D007414:Intestinal Neoplasms / Q000150:complications; D007415:Intestinal Obstruction / Q000209:etiology / Q000628:therapy*