Integration Of Palliative Principles In The Management Of Patients With Compensated And Decompensated Cirrhosis | 58054
Journal of Gastrointestinal & Digestive System
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Introduction: Patients with chronic illnesses such as cirrhosis, often have significant symptoms, psychosocial needs, and desires
for heightened knowledge about their illness. Historically, cirrhosis management has focused on controlling or modifying
cirrhosis progression, and complications of liver dysfunction. Work has started to focus on a parallel pathway of care, involving
symptom management, early advance care planning, and other interventions aimed at improving a patient’s ability to cope with
Discussion: A recent paper was published on August 2016 (Brisebois and Tandon 2016), suggesting various ways to heighten
cirrhosis care early in the disease trajectory. This discussion will provide detailed strategies for GI specialists to integrate
palliative principles into cirrhosis care early in the disease trajectory. Principles to be outlined include modern definitions of
palliative care, how palliative principles can be integrated during acute decompensations, how non-palliative specialists can
provide this type of care, and how palliative care services can aid the Family Practitioners and Gastroenterology Specialists at
various stages of the cirrhosis disease trajectory. This discussion will aim to provide tools for non-palliative care practitioner
to heighten patient support in these areas. Evidence for this care approach will be provided, based on the current literature.
Conclusion: Evidence is increasing for integration of palliative principles early in the cirrhosis disease trajectory. With
continued work, perhaps interdisciplinary collaborations can heighten inclusive patient care and result in increased patient
preparedness for the challenges that come with progressive decline in hepatic function.
Amanda Brisebois is an Internal Medicine and Palliative Care Specialist, who works in Edmonton, Alberta, Canada. She undertook her undergraduate education and Master’s degree at Queen’s University in Kingston, Ontario Canada. She completed her medical school training in Calgary, Alberta, and her General Medicine Specialty at the Mayo Clinic Rochester Minnesota, University of Calgary in Calgary, Alberta, and University of Alberta, in Edmonton. Since 2000, she has been practicing General Internal Medicine in both inpatient and outpatient settings. She also is a certified Palliative Care Specialist.