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Opioid-Related Constipation.

Joy J Liu1, Darren M Brenner1

  • 1Department of Medicine, Division of Gastroenterology/Hepatology, Northwestern University, 676 N St Clair Street, Suite 1400, Chicago, IL 60611, USA.

Gastroenterology Clinics of North America
|February 9, 2022
PubMed
Summary
This summary is machine-generated.

Over-the-counter laxatives are recommended for opioid-induced constipation (OIC) and opioid-exacerbated constipation (OEC). For refractory cases, peripherally acting μ-opioid receptor antagonists offer an effective treatment option.

Keywords:
ConstipationOpioidPAMORAPharmacotherapy

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Area of Science:

  • Gastroenterology
  • Pharmacology

Background:

  • Opioid-related constipation includes opioid-induced constipation (OIC) and opioid-exacerbated constipation (OEC).
  • Effective management strategies are crucial for patient well-being and treatment adherence.

Purpose of the Study:

  • To outline current recommendations for managing opioid-related constipation.
  • To highlight first-line and alternative therapeutic options.

Main Methods:

  • Review of existing literature and clinical guidelines.
  • Assessment of treatment efficacy, safety, and cost-effectiveness.

Main Results:

  • Over-the-counter laxatives are effective, safe, and cost-efficient first-line treatments for both OIC and OEC.
  • The Bowel Function Index can monitor OIC symptoms and treatment response.
  • Peripherally acting μ-opioid receptor antagonists are effective for laxative-refractory OIC.

Conclusions:

  • First-line management of OIC and OEC involves over-the-counter laxatives.
  • Specialized agents are available for refractory OIC, with comparable efficacy among prescription options.