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Constipation and the Cancer Patient

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Presentation transcript:

Anorexia and Cachexia Anorexia – loss of appetite, usually with decreased intake Cachexia – lack of nutrition and wasting Offer favorite foods but educate families about disease process Forcing intake orally or artificially may cause additional suffering

Causes of Anorexia and Cachexia Pre-maturity Disease related Psychological Treatment related

Assessment of Anorexia and Cachexia Physical findings Impact on function and QOL Calorie counts/daily weights Laboratory tests

Treatment of Anorexia and Cachexia Dietary consult/intervention Medications Parenteral/enteral nutrition Education (as artificial nutrition at EOL may increase suffering)

Time with Grandfather

Constipation Infrequent passage of stool Frequent symptom in palliative care Prevention is key Discussion may be difficult with child/adolescent

Causes of Constipation Disease related (e.g. obstruction, hypercalcemia, neurolgic, inactivity) Treatment related (e.g. opioids, other meds)

Assessment of Constipation Bowel history Abdominal assessment Rectal assessment Medication review

Treatment of Constipation Medications Dietary/fluids Popsicles Clear sodas Jello Other approaches

Assessment of Nausea and Vomiting Clinical/physical exam History Lab values BARF scale Minimize suffering

Causes of Nausea and Vomiting Overview/ definition Gastrointestinal causes Metabolic causes CNS causes

Pharmacologic Treatment of Nausea and Vomiting Anticholinergics Antihistamines Steroids Prokinetic agents Other Hellsten & Medellin, 2010; Karwacki, 2006; Santucci & Mack, 2007

Non-Drug Treatment of Nausea and Vomiting Distraction Dietary Small/slow feeding Invasive therapies

Oh, My Child