Palliative Care of GI Issues at the End of Life

  • John M. Heath
  • Elizabeth Poplin


The terminal phase of many chronic GI conditions in the elderly requires careful attention to symptom management. Palliative care provides both a framework, centered on function, and techniques to address common issues such as anorexia, constipation, and intestinal obstruction. Such interventions are not necessarily focused solely on survival but rather on patient well-being during end-of-life care. In this respect, palliative care shares many goals of care with hospice, though unlike hospice, palliative care can be appropriate throughout the course of an illness.


Palliative Care Family Caregiver Palliative Care Team Malignant Bowel Obstruction Stimulant Laxative 
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  1. 1.
    Merriam-Webster Collegiate Dictionary. 10th ed. Springfield: Merriam-Webster; 2001.Google Scholar
  2. 2.
    Dunn GP. Palliative care: a promising philosophical framework for gastroenterology. Gastroenterol Clin North Am. 2006;35:1–21.PubMedCrossRefGoogle Scholar
  3. 3.
    Bakitas M, Doyle Lyons K, Hegel M, et al. Effects of a palliative care intervention on clinical outcomes in patients with advanced cancer. JAMA. 2009;302(7):741–9.PubMedCrossRefGoogle Scholar
  4. 4.
    Gade G, Venohr I, Conner D, et al. Impact of an inpatient palliative care team, a randomized controlled trial. J Palliat Med. 2008;11:80–90.CrossRefGoogle Scholar
  5. 5.
    Temel J, Greer J, Muzikansky A, et al. Early palliative care for patients with metastatic non-small-cell lung cancer. N Engl J Med. 2010;363:733–42.PubMedCrossRefGoogle Scholar
  6. 6.
    DiFrancesco V, Fantin F, Omizzolo F, et al. The anorexia of aging. Dig Dis. 2007;25:129–37.CrossRefGoogle Scholar
  7. 7.
    Mitchell L. Clinical crossroads: a 93-year-old man with advanced dementia and eating problems. JAMA. 2007;298:2527–36.PubMedCrossRefGoogle Scholar
  8. 8.
    Palecek EJ, Teno JM, Cararett DJ, et al. Comfort feeding only: a proposal to bring clarity to decision-making regarding difficulty with eating for persons with advanced dementia. J Am Geriatr Soc. 2010;58(3):580–4.PubMedCrossRefGoogle Scholar
  9. 9.
    August D, Huhmann M. A.S.P.E.N. clinical guidelines: nutrition support therapy during adult anticancer treatment and in hematopoietic cell transplantation. J Parenter Enteral Nutr. 2009;33:472.CrossRefGoogle Scholar
  10. 10.
    Casarett D, Kapo J, Caplan A. Appropriate use of artificial nutrition and hydration-fundamental principles and recommendations. N Engl J Med. 2005;353:2607–15.PubMedCrossRefGoogle Scholar
  11. 11.
    Sampson E, Candy B, Jones L. Enteral tube feeding for older people with advanced dementia. Cochrane Database Syst Rev. 2009:CD007209.Google Scholar
  12. 12.
    Kurien M, McAlindon M, Westaby D, Sanders D. Percutaneous endoscopic gastrostomy (PEG) feeding. Br Med J. 2010; 340:c2414.CrossRefGoogle Scholar
  13. 13.
    Gillick M, Volandes A. The standard of caring: why do we still use feeding tubes in patients with advanced dementia. J Am Med Dir Assoc. 2008;9:364–7.PubMedCrossRefGoogle Scholar
  14. 14.
    Fordyce M. American geriatric society foundation for health and aging patient education forum: end of life care—a guide for patients and caregivers. 2011. Accessed 12 Jan 2011.
  15. 15.
    McCann R, Hall W, Groth-Junker A. Comfort care for the terminally ill patient: the appropriate use of nutrition and hydration. JAMA. 1992;272:1263–6.CrossRefGoogle Scholar
  16. 16.
    New York Department of Health. Medical Orders for Life-Sustaining Treatments. 2011. Accessed 12 Jan 2011.
  17. 17.
    Morrison RS, Meier DE. Palliative Care. N Engl J Med. 2004;350:2582–90.PubMedCrossRefGoogle Scholar
  18. 18.
    Murray SA, Kendall M, Boyd K, Sheikh A. Illness trajectories and palliative care. Br Med J. 2005;330(7498):1007–11.CrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC 2012

Authors and Affiliations

  • John M. Heath
    • 1
  • Elizabeth Poplin
    • 2
  1. 1.Summit Medical GroupBerkeley HeightsUSA
  2. 2.The Cancer Institute of New JerseyRobert Wood Johnson University HospitalNew BrunswickUSA

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