St Ann's Hospice, Manchester, UK.
Manchester MND Care Centre, Salford Royal NHS Foundation Trust, Salford, UK.
BMJ Support Palliat Care. 2017 Sep;7(3):258-260. doi: 10.1136/bmjspcare-2017-001375. Epub 2017 Jul 3.
Dysphagia and weight loss are experienced by up to 80% of patients with motor neuron disease (MND). Enteral tube feeding can benefit these patients but side effects including fullness, bloating, diarrhoea and constipation are frequent and can lead to non-compliance. Changes in feed formulation, regimens and the use of prokinetic medication can help symptoms. We describe a case where the use of gastric pressure relief bags during enteral feeding improved symptoms of bloating in a hospice inpatient with MND. Symptoms recurred when these were not used, which were only partially relieved by manual venting of the gastrostomy tube. We suggest that this simple, non-pharmacological approach to bloating may provide opportunities for symptom relief in the palliative care setting.
约 80%的运动神经元病（MND）患者会出现吞咽困难和体重减轻。肠内管饲可以使这些患者受益，但常见的副作用包括饱胀、腹胀、腹泻和便秘，可导致不遵医嘱。改变喂养配方、方案和使用促动力药物有助于缓解症状。我们描述了一例 MND 临终关怀住院患者在肠内喂养期间使用胃压缓解袋改善腹胀症状的情况。当不使用这些袋子时，症状会再次出现，经手动给胃造口管通气仅部分缓解症状。我们建议，在姑息治疗环境中，这种简单的非药物治疗腹胀的方法可能为缓解症状提供机会。
