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Gastroenterologische Symptomenkontrolle in der Palliativmedizin (Teil 2)

Gastrointestinal symptom control in palliative care (part 2)

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Zusammenfassung

Die Palliativmedizin gewinnt in Deutschland aus gesellschaftlichen, medizinischen und ökonomischen Gründen zunehmend an Bedeutung. Etwa 80% aller palliativmedizinischen Patienten leiden unter gastrointestinalen Symptomen, die zu teilweise extremer Beeinträchtung führen können. In einem zweiteiligen Beitrag soll eine Übersicht über die Möglichkeiten der Symptomenkontrolle, insbesondere der medikamentösen Kontrolle im hausärztlichen bzw. ambulanten Bereich gegeben werden. Auch im zweiten Teil ist es unser Anliegen aufzuzeigen, wie Schwerkranken in der Endphase eine Betreuung im häuslichen Umfeld ermöglicht werden kann. Im ersten Teil ging es um Beschwerden der Mundhöhle sowie Übelkeit und Erbrechen. In diesem Teil sollen Obstipation, Diarrhö, Aszites, Ikterus und die gastrointestinale Obstruktion behandelt werden.

Abstract

Because of current medical and socioeconomic factors, palliative care is gaining increasing importance in Germany. Approximately 80% of all palliative care patients suffer from gastrointestinal symptoms, which can be heavily incapacitating. The object of this two-part review is the control—especially the medical control—of these symptoms in the area of primary care, with the purpose of contributing to the ability of terminally ill patients to receive appropriate medical care at home, thereby avoiding unnecessary hospitalisations. Complaints of the mouth as well as nausea and vomiting were addressed in part I. This second part will deal with constipation, diarrhoea, ascites, jaundice, and gastrointestinal obstruction.

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Authors and Affiliations

  1. Medizinische Klinik I, St.-Vincenz-Krankenhaus, Rottstr. 11, 45711, Datteln, Deutschland

    M. Holtmann

  2. Interdisziplinäre Einrichtung für Palliativmedizin und III. Medizinische Klinik und Poliklinik, Johannes-Gutenberg-Universität, Mainz, Deutschland

    U. Siepmann & S. Mahlkow

  3. Medizinische Klinik und Poliklinik B, Universitätsklinikum, Münster, Deutschland

    D. Domagk

  4. Medizinische Klinik, Gastroenterologie und Palliativmedizin, Euregioklinik, Marienkrankenhaus Nordhorn, Nordhorn, Deutschland

    G. Pott

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  1. M. Holtmann
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  2. U. Siepmann
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  3. S. Mahlkow
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  4. D. Domagk
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  5. G. Pott
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Correspondence to M. Holtmann.

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Holtmann, M., Siepmann, U., Mahlkow, S. et al. Gastroenterologische Symptomenkontrolle in der Palliativmedizin (Teil 2). Gastroenterologe 4, 147–156 (2009). https://doi.org/10.1007/s11377-008-0254-2

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  • DOI: https://doi.org/10.1007/s11377-008-0254-2

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