Gastrointestinal Symptoms in Children With Life-Limiting Conditions Receiving Palliative Home Care

Area of Science:

• Pediatric Palliative Care
• Gastroenterology
• Home Healthcare

Background:

• Children with life-limiting illnesses frequently experience gastrointestinal (GI) symptoms.
• Specialized palliative home care (SPHC) in Germany enables home-based care for these children.
• SPHC involves two phases: stabilization (phase 1) and terminal support (phase 2).

Purpose of the Study:

• To analyze differences in GI symptoms between phase 1 and phase 2 of SPHC.
• To evaluate the causes, treatment modalities, and outcomes of GI symptoms in pediatric palliative home care.

Main Methods:

• Retrospective study conducted from 2014 to 2020.
• Analysis of home visits for 149 children (126 evaluated) focusing on GI symptoms.
• Evaluation of symptom causes, treatments applied, and treatment results.

Main Results:

• GI symptoms were prevalent in both SPHC phases.
• Vomiting was significantly more frequent in phase 2 (59.3% vs. 27.1%, p < 0.001).
• Treatment led to a significant increase in asymptomatic children in phase 1 (40.1% to 75.7%, p < 0.001) and reduced severe constipation in phase 2 (33.9% to 15%, p < 0.05).

Conclusions:

• Painful GI symptoms are common in both phases of pediatric palliative home care, with higher incidence in the terminal phase.
• The severity and frequency of these symptoms can typically be managed effectively within a home care setting.
• Despite limitations (retrospective design, small sample size), the study offers valuable insights into outpatient pediatric palliative care in Germany.