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<p>Malignant bowel obstructions result from unresectable tumors or metastases in the abdominal cavity and are a&#xa0;common complication of advanced cancers such as colorectal and ovarian cancer. They typically affect the small bowel (60%), colon (33%), or both, and cause symptoms such as nausea, vomiting, abdominal pain, and changes in bowel habits. Complete obstruction results in nearly no bowel movement, while incomplete obstruction allows intermittent bowel movement. Differentiating between these two types is often clinically challenging. Treatment includes symptomatic measures such as fluid management, nutrition, pain control, and possible surgical or interventional procedures. For patients with a&#xa0;poor prognosis, palliative care with a&#xa0;focus on quality of life is preferred. Another common symptom of advanced cancer is hepatobiliary pruritus, which is caused by the accumulation of bile salts in the skin, often seen in cholestasis. Treatment includes medications as well as symptomatic measures such as cooling compresses and moisturizers. Opioid-induced constipation is another common symptom in palliative care, caused by opioids used for pain management. It leads to reduced bowel motility and negatively affects patients’ quality of life. Treatment includes nonpharmacological measures such as a&#xa0;high-fiber diet and pharmacological therapies with laxatives and peripherally acting opioid antagonists such as methylnaltrexone and naloxegol. Management of all these symptoms requires interdisciplinary and individualized care that should be discussed early with patients and their families to optimize remaining quality of life and align treatment with patient goals.</p>

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Palliativmedizin: Management von GI-Symptomen

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2025年2月26日

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  • Eva Katharina Masel

摘要

Malignant bowel obstructions result from unresectable tumors or metastases in the abdominal cavity and are a common complication of advanced cancers such as colorectal and ovarian cancer. They typically affect the small bowel (60%), colon (33%), or both, and cause symptoms such as nausea, vomiting, abdominal pain, and changes in bowel habits. Complete obstruction results in nearly no bowel movement, while incomplete obstruction allows intermittent bowel movement. Differentiating between these two types is often clinically challenging. Treatment includes symptomatic measures such as fluid management, nutrition, pain control, and possible surgical or interventional procedures. For patients with a poor prognosis, palliative care with a focus on quality of life is preferred. Another common symptom of advanced cancer is hepatobiliary pruritus, which is caused by the accumulation of bile salts in the skin, often seen in cholestasis. Treatment includes medications as well as symptomatic measures such as cooling compresses and moisturizers. Opioid-induced constipation is another common symptom in palliative care, caused by opioids used for pain management. It leads to reduced bowel motility and negatively affects patients’ quality of life. Treatment includes nonpharmacological measures such as a high-fiber diet and pharmacological therapies with laxatives and peripherally acting opioid antagonists such as methylnaltrexone and naloxegol. Management of all these symptoms requires interdisciplinary and individualized care that should be discussed early with patients and their families to optimize remaining quality of life and align treatment with patient goals.