Screening for Constipation in Palliative Care Patients

Noguera, Antonio Vercher; Centeno, Carlos; Librada, Silvia; Nabal, María

doi:10.1089/jpm.2009.0054

Cited by 18 publications

(16 citation statements)

References 21 publications

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“…This is supported by the findings of Nagaviroj (28) who found no correlation between the subjective and objective measures of constipation. The limited predictive value of subjective scales for constipation including verbal numerical scales have also been found in other palliative settings, for example, in the hospital and in community settings (32). While it is important to document a detailed and accurate patient history, and receive subjective perceptions of bowel function, the literature suggests that this must be balanced with objective measurement.…”

Section: Main Findingsmentioning

confidence: 99%

Assessment and management of constipation for patients receiving palliative care in specialist palliative care settings: A systematic review of the literature

et al. 2018

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Section: Main Findingsmentioning

confidence: 99%

Assessment and management of constipation for patients receiving palliative care in specialist palliative care settings: A systematic review of the literature

et al. 2018

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“…This program gradually decreases the size of the colon to normal size; it then can respond to normal maintenance therapy as described above. A colostomy is not recommended as patients can still get constipated with the colostomy (28,29). Differential diagnosis of constipation in patients with PH/PG includes intestinal pseudo-obstruction (3); the latter is characterized by air in the gastrointestinal tract due to decreased intestinal motility.…”

Section: European Journal Of Endocrinologymentioning

confidence: 99%

Constipation: an overlooked, unmanaged symptom of patients with pheochromocytoma and sympathetic paraganglioma

Thosani

Ayala-Ramirez

Román-Gonzaléz

et al. 2015

European Journal of Endocrinology

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Objective: Pheochromocytomas (PHs) and sympathetic paragangliomas (PGs) are tumors that produce catecholamines, predisposing patients to cardiovascular disease and gastrointestinal effects such as constipation. Objectives: i) determine the prevalence of constipation, its risk factors, and its impact on survival; ii) identify whether a systematic combination of fiber, water, and laxatives was effective for treatment of constipation. Design and methods: We retrospectively studied 396 patients with PH/PG diagnosed in 2005-2014. The study population was patients with constipation as a presenting symptom; the control group was patients without constipation as a presenting symptom. The MD Anderson Symptom Inventory was used to assess constipation and quality of life. Results: Twenty-three patients (6%) had constipation. Constipation was associated with headaches, palpitations, diaphoresis, weight loss, and excessive noradrenaline production (P!0.0001). Eighteen of these patients had non-metastatic primary tumors larger than 5 cm and/or extensive metastases. No statistically significant differences in age, sex, and genotype were noted between the study and control groups. In patients without metastases, resection of the primary tumor led to symptom disappearance. A systematic combination of fiber, water, and laxatives was associated with symptom improvement. Two patients who presented unmanaged constipation died because of sepsis from toxic megacolon. Conclusions: Constipation is a rare and potentially lethal complication in patients with PH/PGs. Severe constipation can be prevented by recognizing and treating mild symptoms.

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“…Constipation for patients in palliative care has been described in various prevalence, from 17-85 % (Abramowitz, Béziaud et al2013, Centeno et al 2009, Clark, Smith et al 2012, Goodman, Low et al 2005, Kirkova, Rybicki et al 2012, Noguera, Centeno et al 2009, Nübling 2014, Potter, Hami et al 2003, Rhondali, Nguyen et al 2013, Saleem 2013, Van Lancher, Velghe et al 2014). …”

Section: Prevalence and Assessment Of Constipation In Palliative Carementioning

confidence: 99%

“…One can ask why? Previous studies have focused on many different symptoms, which give a brief picture of symptom prevalence but only a few studies (Clark, Smith et al 2012, Noguera, Centeno et al 2009, Rhondali, Nguyen et al 2013) have focused deeper on one particular symptom, and dig deeper. To do this, was the second reason for writing this thesis.…”

Section: Rationalementioning

confidence: 99%

Constipation in palliative care : Prevalence, definitions, symptom distress and risk-factors

Erichsén¹

2015

Linköping Studies in Health Sciences. Thesis

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Background and aims: Constipation for patients in palliative care is common and described with variations in prevalence. Side -effects from opioid- treatment, is considered to be one of the main factors leading to constipation. The overall aim of the thesis was to study constipation among patients admitted to specialized palliative care- settings in Sweden. The specific aims of the thesis were 1) To describe and explore the prevalence, definition and symptom distress of constipation by applying different definitions of constipation, in patients admitted to specialized palliative care settings in Sweden. 2) To identify factors related to constipation in patients in specialized palliative care and comparing these factors for patients with different types of constipation to patients without constipation. Methods: A literature- search were conducted where prevalence of- and factors related to constipation was explored and included in a questionnaire, developed for this thesis. Data was collected in a cross- sectional design with a response rate of 50% and analysed with logistic regression. Results: A total of 485 patients from 38 specialized palliative care- units in Sweden participated. Prevalence of constipation for patients in specialized palliative care varied between 7- 43 % depending on definition used. Two different constipation- groups were identified: Medical constipation- group 23% (MCG) and Perceived constipation- group 35% (PCG). Three sub- groups was also identified: patients with i) only ≤ 3 defecations/week, 7%, ii) only perception of being constipated, 19%, and iii) patients with both ≤ 3 defecations/ week and perception of being constipated,16%. Several factors were found to be related to constipation as hospitalisation, absence of laxative- treatment, haemorrhoids, poor appetite, hard stool form and opioids. Conclusions: Prevalence of constipation may differ depending on definitions used. Distress from constipation and other factors related to constipation, than opioids, needs to be incorporated into the clinical constipation- assessment. Validated constipation assessment tool needs to be developed.

The series name Linköping University, Studies in Health Sciences, Thesis in the Licentiate thesis is incorrect. The correct name is Linköping Studies in Health Sciences. Thesis.

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Screening for Constipation in Palliative Care Patients

Cited by 18 publications

References 21 publications

Assessment and management of constipation for patients receiving palliative care in specialist palliative care settings: A systematic review of the literature

Assessment and management of constipation for patients receiving palliative care in specialist palliative care settings: A systematic review of the literature

Constipation: an overlooked, unmanaged symptom of patients with pheochromocytoma and sympathetic paraganglioma

Constipation in palliative care : Prevalence, definitions, symptom distress and risk-factors

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