Jove
Visualize
Contact Us
JoVE
x logofacebook logolinkedin logoyoutube logo
ABOUT JoVE
OverviewLeadershipBlogJoVE Help Center
AUTHORS
Publishing ProcessEditorial BoardScope & PoliciesPeer ReviewFAQSubmit
LIBRARIANS
TestimonialsSubscriptionsAccessResourcesLibrary Advisory BoardFAQ
RESEARCH
JoVE JournalMethods CollectionsJoVE Encyclopedia of ExperimentsArchive
EDUCATION
JoVE CoreJoVE BusinessJoVE Science EducationJoVE Lab ManualFaculty Resource CenterFaculty Site
Terms & Conditions of Use
Privacy Policy
Policies

Related Experiment Videos

Mu-opioid antagonists for opioid-induced bowel dysfunction.

E D McNicol1, D Boyce, R Schumann

  • 1New England Medical Center, Pharmacy and Anesthesia, Box #420, 750 Washington Street, Boston, MA 02111, USA. ewanmcnicol@comcast.net

The Cochrane Database of Systematic Reviews
|April 22, 2008
PubMed
Summary
This summary is machine-generated.

Related Concept Videos

You might also read

Related Articles

Articles linked to this work by shared authors, journal, and citation graph.

Sort by
Same author

[Regression of idiopathic epiretinal membrane-Case report and consideration of the possible mechanism].

Die Ophthalmologie·2022
Same author

The B-APNEIC score: distilling the STOP-Bang questionnaire to identify patients at high risk for severe obstructive sleep apnoea.

Anaesthesia·2021
Same author

[Biomarkers in full-thickness and lamellar defects of the macula].

Der Ophthalmologe : Zeitschrift der Deutschen Ophthalmologischen Gesellschaft·2021
Same author

Use of Helmet CPAP in COVID-19 - A practical review.

Pulmonology·2021
Same author

International multicentre review of perioperative management and outcome for catecholamine-producing tumours.

The British journal of surgery·2020
Same author

Knowledge and comfort with neonatal resuscitation among practising anesthesiologists.

International journal of obstetric anesthesia·2019
Same journal

Mechanical thromboprophylaxis for preventing intradialytic hypotension in people undergoing maintenance haemodialysis.

The Cochrane database of systematic reviews·2026
Same journal

Prognostic models for predicting intensive care unit admission or mortality in critically ill adults not yet been admitted to the intensive care unit.

The Cochrane database of systematic reviews·2026
Same journal

Views and experiences of weight management for people living with mobility‑limiting conditions, intellectual disabilities or severe mental illness: a qualitative evidence synthesis.

The Cochrane database of systematic reviews·2026
Same journal

Non-pharmacological interventions for anxiety and depression in Parkinson's disease.

The Cochrane database of systematic reviews·2026
Same journal

Biologic drugs for induction and maintenance of remission in Crohn's disease: a network meta-analysis.

The Cochrane database of systematic reviews·2026
Same journal

Preconception and first-trimester metformin for improving pregnancy outcomes in women with polycystic ovary syndrome.

The Cochrane database of systematic reviews·2026
See all related articles

Alvimopan and methylnaltrexone show promise for treating opioid-induced bowel dysfunction (OBD), effectively reversing constipation and gastrointestinal issues. Further research is needed to confirm long-term safety and efficacy of these and other opioid antagonists for OBD management.

Area of Science:

  • Gastroenterology
  • Pharmacology
  • Clinical Trials

Background:

  • Opioid-induced bowel dysfunction (OBD) presents as constipation, bloating, and reflux, impacting patient morbidity and quality of life.
  • OBD can manifest acutely or chronically across various disease states.

Purpose of the Study:

  • To evaluate and compare the efficacy and safety of peripherally acting opioid antagonists against traditional interventions for OBD.
  • To synthesize evidence from randomized controlled trials on mu-opioid antagonists for OBD treatment.

Main Methods:

  • Systematic literature search of MEDLINE, Cochrane Central Register, and EMBASE up to January 2007.
  • Inclusion of randomized controlled trials (RCTs) investigating mu-opioid antagonists for OBD.
  • Data extraction on patient demographics, diagnoses, interventions, efficacy outcomes, and adverse events.

Related Experiment Videos

Main Results:

  • Twenty-three RCTs involving 2871 patients were analyzed, focusing on alvimopan, methylnaltrexone, naloxone, and nalbuphine.
  • Methylnaltrexone and alvimopan demonstrated superior efficacy over placebo in improving gastrointestinal transit time and constipation.
  • Alvimopan showed safety and efficacy in managing postoperative ileus, with adverse events comparable to placebo.

Conclusions:

  • Limited evidence supports the use of naloxone or nalbuphine for OBD treatment.
  • Long-term safety and efficacy data for all opioid antagonists remain insufficient, as do details on rare adverse events.
  • Alvimopan and methylnaltrexone show potential for OBD management, but require further investigation for definitive therapeutic roles.