Lack of appetite

Start by determining if lack of appetite is reversible: check for constipation, nausea, poor oral hygiene, thrush.

If due to cachexia from disease see the talk tips at the bottom of the page.

Drugs

Appetite stimulants

  • usually not effective in patients with advanced disease

Corticosteroids

  • dexamethasone 4mg po/sc in a.m. may help temporarily

Treat early satiety with metoclopramide or domperidone

Other therapies

  • treat reversible causes
  • eating is for pleasure only in advanced illness
  • suggest eating small amounts of favourite foods that are tolerated

Talk tip: if the patient has cachexia, emphasize to patient/family that patient is declining because of disease not because they are not eating. Focus on hunger and thirst needs, not hydration and nutrition. If appropriate, review natural process of dying and that it’s natural to not want to eat and drink.

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