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Related Experiment Videos

Constipation in advanced cancer patients

I Mancini1, E Bruera

  • 1Palliative Care Programme, Grey Nuns Community Hospital & Health Centre, Edmonton, Canada.

Supportive Care in Cancer : Official Journal of the Multinational Association of Supportive Care in Cancer
|August 8, 1998
PubMed
Summary

Constipation is a common issue in advanced cancer patients, often caused by opioid use. Effective management requires careful patient assessment and interventions like laxatives.

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Area of Science:

  • Oncology
  • Gastroenterology
  • Palliative Care

Background:

  • Constipation is a frequent and distressing complication in advanced cancer patients.
  • Opioid use, a common analgesic in cancer care, significantly contributes to constipation by altering intestinal motility and secretions.
  • Untreated constipation can lead to severe complications, impacting patient quality of life.

Purpose of the Study:

  • To review the pathophysiology and causes of constipation in advanced cancer.
  • To elucidate the specific effects of opioids on the gastrointestinal tract.
  • To propose a structured approach for the assessment and management of constipation in this patient population.

Main Methods:

  • Literature review focusing on pathophysiology, causes, and opioid effects on the gastrointestinal tract.
  • Discussion of diagnostic assessment including patient history, physical examination, and imaging when necessary.
  • Outline of management strategies encompassing general interventions and therapeutic options.

Main Results:

  • Opioids reduce intestinal motility and secretions, increase fluid absorption, and affect blood flow, leading to constipation.
  • Comprehensive assessment is crucial for diagnosis, involving detailed history, physical and rectal examinations, and potentially abdominal X-rays.
  • Management involves general measures (comfort, privacy, addressing contributing medical factors) and pharmacological treatments (laxatives, prokinetics, naloxone).

Conclusions:

  • Constipation is a significant challenge in advanced cancer, frequently exacerbated by opioid therapy.
  • A systematic approach to assessment and management, combining general and therapeutic interventions, is essential.
  • Further research, including randomized clinical trials on laxatives and prokinetics, and validation of assessment tools, is needed.

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