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Related Experiment Video

Updated: Jul 5, 2026

Functional Assessment of Intestinal Motility and Gut Wall Inflammation in Rodents: Analyses in a Standardized Model of Intestinal Manipulation

Functional Assessment of Intestinal Motility and Gut Wall Inflammation in Rodents: Analyses in a Standardized Model of Intestinal Manipulation

Published on: September 11, 2012

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

Summary

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.

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Gastrointestinal Motility Monitor (GIMM)

Gastrointestinal Motility Monitor (GIMM)

Published on: December 1, 2010

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Last Updated: Jul 5, 2026

Functional Assessment of Intestinal Motility and Gut Wall Inflammation in Rodents: Analyses in a Standardized Model of Intestinal Manipulation

Functional Assessment of Intestinal Motility and Gut Wall Inflammation in Rodents: Analyses in a Standardized Model of Intestinal Manipulation

Published on: September 11, 2012

Gastrointestinal Motility Monitor (GIMM)

Gastrointestinal Motility Monitor (GIMM)

Published on: December 1, 2010

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.

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.