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Related Concept Videos

Drugs for Treatment of Constipation-Predominant IBS01:21

Drugs for Treatment of Constipation-Predominant IBS

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Pharmacological therapies for IBS-C are designed to alleviate abdominal discomfort and enhance bowel function. In patients with IBS-C, fiber supplements may help soften stools and decrease straining, but may also lead to increased gas production and bloating. Osmotic laxatives like milk of magnesia are frequently used to soften stools and increase stool frequency in IBS-C patients. In addition, two drugs approved for use in severe IBS-C adult cases are linaclotide (Linzess) and lubiprostone...
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Drugs for Treatment of Diarrhea-Predominant IBS01:17

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Diarrhea-predominant irritable bowel syndrome (IBS-D) is a subtype of IBS characterized primarily by frequent, loose, or watery stools, abdominal pain, and abdominal discomfort. Therapeutic approaches to managing IBS-D include dietary changes, stress management techniques, and pharmaceutical interventions.
Two specific drugs used in the treatment are alosetron (Lotronex) and eluxadoline (Viberzi). Alosetron, a 5-HT3 antagonist, works by slowing the movement of stools in the gut, reducing bowel...
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Drugs Affecting GI Tract Motility: Opioids as Antidiarrheal Agents01:17

Drugs Affecting GI Tract Motility: Opioids as Antidiarrheal Agents

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Diarrhea, a condition marked by frequent loose or watery bowel movements, can be triggered by multiple factors such as viral or bacterial infections, food intolerances, anxiety, medications, and digestive disorders. Symptoms may include abdominal pain, bloating, nausea, and cramping. Severe or prolonged diarrhea can lead to complications like electrolyte imbalances, malnutrition, and dehydration if left untreated.
Opioids, widely used antidiarrheal agents, mitigate diarrhea by slowing down...
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Opioid Analgesics: Synthetic and Semisynthetic Opioids01:15

Opioid Analgesics: Synthetic and Semisynthetic Opioids

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Synthetic and semisynthetic opioids are pivotal in pain management and tackling opioid addiction. Semisynthetic opioids, including morphinans (morphine derivatives), oxycodone, oxymorphone, hydrocodone, and hydromorphone, have improved pharmacokinetic profiles compared to morphine. Additionally, heroin and 6-MAM (6-Monoacetylmorphine) show better CNS penetration than morphine due to heightened lipid solubility. Hydromorphone, a potent opioid, undergoes hepatic metabolism to form the active...
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Inflammatory Bowel Disease V: Surgical Management01:21

Inflammatory Bowel Disease V: Surgical Management

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Surgical interventions for inflammatory bowel disease (IBD), which includes ulcerative colitis and Crohn's disease, are essential in managing symptoms and addressing complications. The selection of surgical procedures is contingent upon the specific conditions and complications that stem from these illnesses.
Here are some common surgical interventions for IBD:
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Analgesia and Pain Management01:25

Analgesia and Pain Management

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Pain is critical to various clinical pathologies, provoking an urgent need for effective management. Pain, whether acute or chronic, is a complex neurochemical process. Its alleviation depends on the type, with nonopioid analgesics effective for mild to moderate pain, such as musculoskeletal or inflammatory pain, while neuropathic pain responds best to anticonvulsants, tricyclic antidepressants, or serotonin/norepinephrine reuptake inhibitors. For severe acute or chronic pain, opioids may be...
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Related Experiment Video

Updated: Oct 25, 2025

Acupoint Application Combined with Acupoint Massage for Treating Constipation in a Patient with Chronic Obstructive Pulmonary Disease
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Opioid-induced constipation: a stepwise treatment algorithm feasibility study.

Andrew Neil Davies1,2, Charlotte Leach3, Claire Butler4

  • 1Academic Department of Palliative Medicine, Trinity College Dublin, Dublin, Ireland andavies@tcd.ie.

BMJ Supportive & Palliative Care
|August 5, 2021
PubMed
Summary
This summary is machine-generated.

A feasibility study suggests a stepwise treatment algorithm effectively manages opioid-induced constipation (OIC) in advanced cancer patients. Utilizing the Bowel Function Index (BFI) for monitoring and treatment decisions showed clinically important improvements in OIC symptoms.

Keywords:
cancerconstipation

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Area of Science:

  • Oncology
  • Gastroenterology
  • Clinical Pharmacology

Background:

  • Opioid-induced constipation (OIC) is a common and often undertreated adverse effect in advanced cancer patients.
  • A stepwise treatment algorithm combined with patient-reported outcome measures (PROMs) may improve OIC management.

Purpose of the Study:

  • To assess the feasibility of conducting a definitive study on OIC management using a treatment algorithm and PROMs.
  • To determine if this approach can lead to clinically significant improvements in OIC.

Main Methods:

  • A feasibility study involving 100 patients with OIC (Rome criteria, BFI ≥30).
  • Weekly assessments using the Bowel Function Index (BFI) to guide management decisions based on a four-step algorithm.
  • Treatment adjustments were based on current BFI scores and treatment tolerability.

Main Results:

  • 79 out of 100 patients completed the study.
  • 72% of participants responded to treatment, with 43% achieving a complete response (BFI <30) and 29% a partial response (BFI change ≥12).
  • Treatment regimens included conventional laxatives, peripherally acting mu-opioid receptor antagonists (PAMORAs), or a combination.

Conclusions:

  • The feasibility study indicates that a definitive study on OIC management is achievable.
  • The BFI and treatment algorithm approach showed potential for clinically important improvements in OIC.
  • Methodological refinements will focus on improving recruitment, retention, and adherence for future studies.