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Behandlung gastrointestinaler Symptome in der Palliativsituation

Palliative treatment of gastrointestinal symptoms

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Zusammenfassung

Gastrointestinale Symptome treten bei ca. 80% aller palliativmedizinischen Patienten auf, unabhängig von der Primärdiagnose. Ziel der palliativmedizinischen Versorgung ist die Kontrolle dieser Symptome als Beitrag zur Sicherung von Lebensqualität in der Endphase der Erkrankungen. Diese letzte Lebensphase sollte der Patient in der von ihm gewünschten Umgebung verbringen können; dies ist in der Regel zuhause. Anliegen dieser Übersicht ist es, für die Behandlung der Kardinalsymptome Übelkeit und Erbrechen, Obstipation und Aszites praxisorientierte Vorschläge zu machen, die gerade dem palliativmedizinisch tätigen Hausarzt die Möglichkeit geben sollen, seine Schwerkranken auch in der Endphase im häuslichen Umfeld zu versorgen – unter Vermeidung unnötiger stationärer Aufenthalte. Viele Maßnahmen sind in der besonderen palliativmedizinischen Situation nicht durch Studien in ihrer Wirksamkeit belegt. Der Off-Label-Einsatz von Medikamenten hat eine große Bedeutung.

Abstract

Gastrointestinal symptoms occur in approximately 80% of palliative care patients independent of the primary diagnosis. Palliative care aims at controlling these symptoms to contribute to quality of life in the end stage of disease. Patients should be able to spend the final phase of their life in their surrounding of choice, mostly at home. The object of this review is to give an overview on the control, especially the medical control of common symptoms, such as nausea and vomiting, constipation and ascites. Many procedures in palliative care are not evidence-based. Off-label use of drugs plays an important role.

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Authors and Affiliations

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

    M. Floer & D. Domagk

  2. Medizinische Klinik III, St.-Vincenz-Krankenhaus, Rottstr. 11, 45711, Datteln, Deutschland

    M.H. Holtmann

Authors
  1. M. Floer
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  2. D. Domagk
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  3. M.H. Holtmann
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Correspondence to M.H. Holtmann.

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Floer, M., Domagk, D. & Holtmann, M. Behandlung gastrointestinaler Symptome in der Palliativsituation. Gastroenterologe 6, 371–379 (2011). https://doi.org/10.1007/s11377-011-0546-9

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