Gastrointestinal Symptoms

Gastrointestinal symptoms include a broad spectrum of clinical conditions, ranging from mildly irritating (aphthous ulcers) to functionally disabling (constipation and mucositis). Symptoms can originate anywhere along the gastrointestinal tract from the mouth to the rectum. Children may suffer greatly, as many of the medications used to treat their symptoms have only limited efficacy. Furthermore, suffering takes many forms, not just physical, and the intrinsic interdisciplinary nature of pediatric palliative care lends itself to attending to the psychological and sometimes existential and spiritual suffering that can accompany disabling gastrointestinal symptoms. This chapter will provide a comprehensive, evidence-based, and interdisciplinary approach to gastrointestinal symptoms that afflict seriously ill children. The assessment and treatment of these symptoms is always undertaken within the context of the child’s and family’s goals of care.