Clinical Guidelines for Management of Gastrointestinal Symptoms in Cancer Patients: The Japanese Society of Palliative Medicine Recommendations

J Palliat Med. 2019 Aug;22(8):986-997. doi: 10.1089/jpm.2018.0595. Epub 2019 Apr 2.

Abstract

Background: Gastrointestinal symptoms, including nausea, vomiting, bowel obstruction, ascites, constipation, and anorexia, are common and often refractory in advanced cancer patients. The palliation of gastrointestinal symptoms is important in improving the quality of life of cancer patients, as well as that of their families and caregivers. Currently published clinical guidelines for the management of gastrointestinal symptoms in cancer patients do not comprehensively cover the topics or are not based on a formal process for the development of clinical guidelines. Methods: The Japanese Society for Palliative Medicine (JSPM) developed comprehensive clinical guidelines for the management of gastrointestinal symptoms in cancer patients after a formal guideline development process. Results: This article summarizes the recommendations along with their rationale and a short summary of the development process of the JSPM gastrointestinal symptom management guidelines. We established 31 recommendations, all of which are based on the best available evidence and agreement of expert taskforce members. Discussion: Future clinical studies and continuous guideline updates are required to improve gastrointestinal symptom management in cancer patients.

Keywords: anorexia; ascites; bowel obstruction; constipation; nausea; vomiting.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Anorexia / drug therapy
  • Anorexia / nursing
  • Antiemetics / therapeutic use*
  • Constipation / drug therapy
  • Constipation / nursing
  • Female
  • Gastrointestinal Diseases / drug therapy*
  • Gastrointestinal Diseases / etiology*
  • Gastrointestinal Diseases / nursing*
  • Humans
  • Japan
  • Male
  • Middle Aged
  • Nausea / drug therapy
  • Nausea / nursing
  • Neoplasms / complications*
  • Palliative Care / standards*
  • Practice Guidelines as Topic*
  • Vomiting / drug therapy
  • Vomiting / nursing

Substances

  • Antiemetics