Gastrointestinal symptoms and problems in children cared by pediatric palliative care teams. Observational study

Gastrointestinal symptoms and problems in children cared by pediatric palliative care teams. Observational study

Bernada Scarrone MM; Le Pera Garofalo V

Andes Pediatrica

2024

child; Palliative Care; article; human; major clinical study; quality of life; preschool child; palliative therapy; consultation; school child; observational study; prospective study; multicenter study; prevalence; adolescent; dysphagia; gastrostomy; constipation; infant; questionnaire; nausea; diarrhea; pediatric patient; vomiting; abdominal pain; mucosa inflammation; gastrointestinal symptom; digestive prosthesis; digestive system hemorrhage

Gastrointestinal symptoms and problems (GI-SP) frequently cause discomfort and suffering in pediatric patients with life-threatening and/or life-limiting illnesses (LTI/LLI). Pediatric palliative care (PPC) professionals should be aware of them and perform a comprehensive approach. Objective(s): To determine the prevalence of GI-SP in patients treated in PPC units and to describe the pharmacological and non-pharmacological measures prescribed. Patients and Method: Observational, prospective, multicenter, prospective study in patients with LTI/LLI, seen by PPC teams in Uruguay. The variables analyzed included age, sex, origin, type of LTI/LLI, presence of mucositis, vomiting, swallowing disorders, abdominal pain, constipation, diarrhea, digestive bleeding, problems with digestive prosthesis, and prescribed pharmacological and non-pharmacological treatment. Result(s): 10 out of 16 PPC teams participated. 96 out of 436 patients seen presented GI-SP (22%). Median age was 4.2 years (1 month-18 years). LTI/LLI: 65% neurological and 7% oncological. The 96 patients had 114 consultations; 50% had 2 or more GI-SP per consultation. GI-SP observed: swallowing disorders (57%), constipation (53%), nausea and/or vomiting (24%), gastrostomy problems (17%), abdominal pain (10%), digestive bleeding (3%), and diarrhea (2%). There were variable prescriptions of pharmacological and non-pharmacological measures; only 50% of those with swallowing disorder received speech and hearing therapy. Conclusion(s): GI-SP motivated consultations in all PPC settings, frequently due to 2 or more GI-SP. Swallowing disorders and gastrostomy complications are frequent but not very visible problems in PPC. According to the comprehensive approach, pharmacological and non-pharmacological measures were implemented.Copyright © 2024, Sociedad Chilena de Pediatria. All rights reserved.

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