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Diagnosis, Assessment and Management of Constipation in Advanced Cancer: ESMO Clinical Practice Guidelines CLINICAL PRACTICE GUIDELINES Diagnosis, assessment and management of constipation in advanced cancer: ESMO Clinical Practice Guidelines † P. J. Larkin 1,2 , N. I. Cherny 3 , D. La Carpia 4 , M. Guglielmo 5 , C. Ostgathe 6 , F. Scotte ´ 7 & C. I. Ripamonti 5 ,on behalf of the ESMO Guidelines Committee * 1 School of Nursing, Midwifery and Health Systems, University College Dublin, Dublin; 2 (...) by the patient and diagnostic criteria do not always clearly ex- press the diversity of factors, which may lead to constipation as a clinical problem . Widespread use of opioid analgesics for cancer pain poses speci?c challenges for patients . Despite its clinical im- pact, constipation is both poorly recognised and poorly treated. Oncologists must be familiar with the common causes of constipa- tion among cancer patients and the strategies to evaluate and man- age this distressing symptom
% of people with cancer will require treatment with laxatives at some time. People receiving palliative care have multiple (...) causes of constipation , such as: Drugs, for example, opioid analgesics, antimuscarinic drugs, antacids. Secondary effects of disease, for example, dehydration, inadequate dietary fibre, inactivity, delirium, spinal cord compression, lack of privacy. Direct effects of malignant tumours, causing bowel obstruction, hypercalcaemia, nerve damage. When assessing a person (...) Constipation Top results for constipation - Trip Database or use your Google+ account Liberating the literature ALL of these words: Title only Anywhere in the document ANY of these words: Title only Anywhere in the document This EXACT phrase: Title only Anywhere in the document EXCLUDING words: Title only Anywhere in the document Timeframe: to: Combine searches by placing the search numbers in the top search box and pressing the search button. An example search might look like (#1 or #2
| | | Constipation is by far the most common and debilitating gastrointestinal effect of opioids, and some degree of constipation is near universal in patients taking opioid medications. x 11 Bell, T.J., Panchal, S.J., Miaskowski, C. et al. The prevalence, severity, and impact of opioid-induced bowel dysfunction: results of a US and European Patient Survey (PROBE 1). Pain Med . 2009 ; 10 : 35–42 | | | , x 12 Sykes, N.P. The relationship between opioid use and laxative use in terminally ill cancer patients (...) . 2009 ; 10 : 35–42 | | | , x 15 Abramowitz, L., Beziaud, N., Labreze, L. et al. Prevalence and impact of constipation and bowel dysfunction induced by strong opioids: a cross-sectional survey of 520 patients with cancer pain: DYONISOS study. J Med Econ . 2013 ; 16 : 1423–1433 | | | , x 16 Kalso, E., Edwards, J.E., Moore, R.A. et al. Opioids in chronic non-cancer pain: systematic review of efficacy and safety. Pain . 2004 ; 112 : 372–380 | | | | | OIC by definition is a condition associated
Randomized Phase III and Extension Studies of Naldemedine in Patients With Opioid-Induced Constipation and Cancer Purpose Opioid-induced constipation (OIC) is a frequent and debilitating adverse effect (AE) of opioids-common analgesics for cancer pain. We investigated the efficacy and safety of a peripherally acting μ-opioid receptor antagonist, naldemedine (S-297995), for OIC, specifically in patients with cancer. Patients and Methods This phase III trial consisted of a 2-week, randomized (...) , double-blind, placebo-controlled study (COMPOSE-4) and an open-label, 12-week extension study (COMPOSE-5). In COMPOSE-4, eligible adults with OIC and cancer were randomly assigned on a 1:1 basis to receive once-daily oral naldemedine 0.2 mg or placebo. The primary end point was the proportion of spontaneous bowel movement (SBM) responders (≥ 3 SBMs/week and an increase of ≥ 1 SBM/week from baseline). The primary end point of COMPOSE-5 was safety. Results In COMPOSE-4, 193 eligible patients were
Phase IIb, Randomized, Double-Blind, Placebo-Controlled Study of Naldemedine for the Treatment of Opioid-Induced Constipation in Patients With Cancer Purpose This randomized, double-blind, multicenter study aimed to determine the dose of naldemedine, a peripherally-acting μ-opioid receptor antagonist, for future trials by comparing the efficacy and safety of three doses of naldemedine versus placebo in patients with cancer and opioid-induced constipation. Methods Patients ≥ 18 years old (...) with cancer, an Eastern Cooperative Oncology Group performance status ≤ 2, who had been receiving a stable regimen of opioid analgesics for ≥ 2 weeks, had at least one constipation symptom despite laxative use, and no more than five spontaneous bowel movements (SBMs) during the past 14 days, were randomly assigned (1:1:1:1) to oral, once-daily naldemedine 0.1, 0.2, or 0.4 mg, or placebo, for 14 days. The primary end point was change in SBM frequency per week from baseline during the treatment period
Hong Kong Chinese Medicine Clinical Practice Guideline for Cancer Palliative Care: Pain, Constipation, and Insomnia. It is common for patients with cancers in Hong Kong seeking Chinese Medicine (CM) therapies as supportive care during cancer treatment and to manage treatment-related side effects. This article provides clinical practice guideline (CPG) on the use of CM for specific clinical indications caused by cancer and during cancer treatment, including pain, constipation, and insomnia
for alarm features ( ) that require additional investigations to rule out structural diseases (eg, colon cancer). , Mrs N.M. does not have any alarm features. Box 2. Alarm features of constipation Most important questions to ask your patient: Have you had any fever, had unintentional weight loss, had blood in or on your stool, felt any masses (abdominal or rectal), had night symptoms, or had any other unexplained symptoms? Are you vomiting? Do you have a lot of abdominal pain? Are you still passing gas (...) ? Do you have a family history of colon cancer or inflammatory bowel disease? Other alarm features: Age older than 50 y with recent onset of symptoms Abnormal laboratory bloodwork results (eg, anemia or iron deficiency) Step 3: Identify and treat reversible causes A number of diseases and conditions have been suspected of causing constipation ( ). , , Optimizing the management of these diseases, when possible, should be attempted in an effort to lessen or resolve the constipation. However
Effect of auricular points treatment combined with acupoints application in patients with constipation after lung cancer surgery. To assess the effect of auricular points treatment combined with acupoints application on patient with constipation after lung cancer surgery.Design and participants: This is a single-center randomized controlled trial. Totally 341 after lung cancer surgery patients were randomly assigned into the experimental group (n = 174) and the control group (n = 167 (...) of constipation in the control group was higher than that in the experimental group (P < 0.001). Moreover, the stool characteristics of experimental group were better than it in the control group by rank-sum test (P = 0.047).On the basis of routine measures to prevent constipation after lung cancer surgery, auricular point sticking combined with acupoint application therapy can effectively decrease the incidence of postoperative constipation.
Randomized Phase III and Extension Studies of Naldemedine in Patients With Opioid-Induced Constipation and Cancer. 29406801 2018 03 28 1527-7755 36 10 2018 Apr 01 Journal of clinical oncology : official journal of the American Society of Clinical Oncology J. Clin. Oncol. Randomized Phase III and Extension Studies of Naldemedine in Patients With Opioid-Induced Constipation and Cancer. 1049-1050 10.1200/JCO.2017.76.9349 Yagi Yukako Y Yukako Yagi and Kazuhiro Kosugi, National Cancer Center (...) Hospital East, Chiba, Japan; and Tetsuya Tanimoto, Jyoban Hospital of Tokiwa Foundation, Fukushima, Japan. Kosugi Kazuhiro K Yukako Yagi and Kazuhiro Kosugi, National Cancer Center Hospital East, Chiba, Japan; and Tetsuya Tanimoto, Jyoban Hospital of Tokiwa Foundation, Fukushima, Japan. Tanimoto Tetsuya T Yukako Yagi and Kazuhiro Kosugi, National Cancer Center Hospital East, Chiba, Japan; and Tetsuya Tanimoto, Jyoban Hospital of Tokiwa Foundation, Fukushima, Japan. eng Journal Article 2018 02 06 United
Long-term use of naldemedine in the treatment of opioid-induced constipation in patients with chronic non-cancer pain: a randomized, double-blind, placebo-controlled phase 3 study. The long-term safety of naldemedine, a peripherally acting µ-opioid receptor antagonist, was evaluated in patients with opioid-induced constipation and chronic noncancer pain in a 52-week, randomized, double-blind, phase 3 study. Eligible adults who could be on a routine laxative regimen were randomized 1:1 (...) to receive once-daily oral naldemedine 0.2 mg (n = 623) or placebo (n = 623). The primary endpoint was summary measures of treatment-emergent adverse events (AEs). Additional endpoints included opioid withdrawal on the Clinical Opiate Withdrawal Scale and the Subjective Opiate Withdrawal Scale, pain intensity on Numeric Rating Scale, frequency of bowel movements, and constipation-related symptoms and quality of life on the Patient Assessment of Constipation Symptoms and Patient Assessment of Constipation
Chinese herbal medicine for opioid induced constipation in cancer patients: Protocol for a systematic review. Opioid induced constipation (OIC) is a symptom that is commonly encountered in cancer pain management. Chinese herbal medicine (CHM) has been widely used to improve OIC in China. Many clinical trials indicate that CHM could improve OIC. In this systematic review, we aim to evaluate the effectiveness and safety of CHM for OIC in cancer patients.We will search the following electronic (...) databases for randomized controlled trials to evaluate the effectiveness and safety of CHM for OIC in cancer patients: CENTRAL, EMBASE, MEDILINE, CINAHL and China National Knowledge Infrastructure. Each database will be searched from inception to June 2018. The entire process will include study selection, data extraction, risk of bias assessment and meta-analyses.This proposed study will evaluate the effectiveness and safety of CHM for OIC. The outcomes will include change in bowel movements, quality
Risk of Major Adverse Cardiovascular Events for Naldemedine and Other Medications for Opioid Induced Constipation in Adults With Chronic Non-Cancer Pain Risk of Major Adverse Cardiovascular Events for Naldemedine and Other Medications for Opioid Induced Constipation in Adults With Chronic Non-Cancer Pain - Full Text View - ClinicalTrials.gov Hide glossary Glossary Study record managers: refer to the if submitting registration or results information. Search for terms x × Study Record Detail (...) Saved Studies Save this study Warning You have reached the maximum number of saved studies (100). Please remove one or more studies before adding more. Risk of Major Adverse Cardiovascular Events for Naldemedine and Other Medications for Opioid Induced Constipation in Adults With Chronic Non-Cancer Pain The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been evaluated by the U.S. Federal Government
Randomized phase 3 and extension studies: Efficacy and impacts on quality of life of naldemedine in subjects with opioid-induced constipation and cancer. The efficacy and safety of naldemedine (a peripherally-acting µ-opioid receptor antagonist) for opioid-induced constipation (OIC) in subjects with cancer was demonstrated in the primary report of a phase 3, double-blind study (COMPOSE-4) and its open-label extension (COMPOSE-5). The primary endpoint, the proportion of spontaneous bowel (...) movement (SBM) responders, was met. Here, we report results from secondary endpoints including quality of life (QOL) assessments from these studies.In COMPOSE-4, eligible adults with OIC and cancer were randomly assigned 1:1 to receive once-daily oral naldemedine 0.2 mg (n=97) or placebo (n=96) for 2 weeks, and those who continued on to COMPOSE-5 received naldemedine for 12 weeks (n=131). Secondary assessments in COMPOSE-4 included the proportion of complete SBM (CSBM) responders, SBM or CSBM
Cystic Fibrosis & disorders of the large intestine: DIOS, constipation, and colorectal cancer. Since 1966 when the Cystic Fibrosis Foundation Patient Registry (CFFPR) was founded, clinicians have witnessed significant advances in both the quality and quantity of life for patients living with Cystic Fibrosis (CF). As patients with CF live longer and fuller lives, increasing encumbrances from gastrointestinal manifestations of CF will be observed. This article serves to discuss "below (...) the diaphragm" concerns involving the large intestine (Distal Intestinal Obstruction Syndrome, Constipation, and Colorectal Cancer). Avenues for development and implementation of clinical care protocols, particularly regarding proactive management of known associated conditions and cancer screening, will continue to be refined in the coming years. It falls to the multidisciplinary CF care team to be actively engaged in addressing these concerns effectively as priority shifts from relative acuity (typically
The Efficacy and Safety of Transcutaneous Acupoint Interferential Current Stimulation for Cancer Pain Patients With Opioid-Induced Constipation: A Prospective Randomized Controlled Study Opioid-induced constipation (OIC) is a principal complication secondary to analgesic therapy for cancer pain patients who suffer moderate to severe pain. In this study, we observe the efficacy and safety of transcutaneous acupoint interferential current (IFC) stimulation in those patients with OIC.A total (...) , P = .041, P = .011, respectively).Transcutaneous acupoint IFC therapy over acupoints of Tianshu (ST25) and Zhongwan (RN12) may improve constipation and quality of life in cancer patients receiving opiates; further studies are worthwhile.
Managing Constipation in Adults With CancerConstipation is common in individuals with cancer, occurring in almost 60% of patients overall. The incidence increases in patients with advanced disease, particularly in those receiving opioid analgesics or medications with anticholinergic properties. Constipation is not uniformly assessed and therefore not recognized and appropriately managed in many instances. This can increase patients' physical and psychological distress. Furthermore (...) , there is scant research to support current management strategies for constipation. The objectives of this review are to explore the incidence of and risk factors for constipation in patients with cancer, to discuss the extent of the problem, to explore the nonpharmacologic and pharmacologic measures for constipation and fecal impaction, and to synthesize a laxative management. An extensive review of medical, pharmacy, and nursing literature was done to explore the physiology and pathogenesis of constipation
Colorectal Cancer Presenting with Constipation During Pregnancy Colorectal cancer is a rare occurrence during pregnancy and can present with symptoms that are common during pregnancy such as constipation.This can make the diagnosis of colorectal cancer during pregnancy difficult. Management of colorectal cancer during pregnancy is similar to the treatment of non-pregnant patients, but with fetal safety in mind. This case report describes a 33-year-old female gravida two para one (G2P1) at 29 (...) weeks gestation who presented with a complete bowel obstruction. Colonoscopy, magnetic resonance imaging (MRI) and later resection showed an obstructing malignancy which was then resected through an exploratory laparotomy with left hemicolectomy. Postoperatively, there was a concern for sepsis, so labor was induced and the baby was delivered vaginally. The patient then continued with chemotherapy with hematology-oncology. High clinical suspicion is needed to diagnose colorectal cancer during
Easing the strain: put your feet up for constipation Easing the strain: put your feet up for constipation - Evidently Cochrane Search and hit Go By February 24, 2016 // In this guest blog, pelvic physiotherapist and comedian Elaine Miller tells us what we need to know to avoid constipation and when the going gets tough. This is the third blog in our new series Evidence for Everyday Health Choices. Constipation is a miserable condition which can worsen co-morbidities like low back pain, muscle (...) tone problems in people with neurological conditions and confusion in people with dementia. It is therefore a condition that needs to be understood and managed – but there is a dearth of research to guide us. One of the main issues is encouraging people to seek help. Many people are simply too embarrassed to see their GP about bowel problems, which is a problem because one of the signs of colon cancer is a disruption in habits which lasts for longer than three weeks. Therefore, I don’t discourage