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Intestinal pseudo-obstruction associated with oral morphine
B V Murthy1, F Ion, J R Winstanley
1Department of Anaesthesia, Royal Liverpool University Hospital, UK.
European Journal of Anaesthesiology
|July 3, 1998
Summary
Oral morphine, recommended for cancer pain, can cause severe constipation. This case study highlights intestinal pseudo-obstruction as a potential complication in terminally ill cancer patients using strong opioids.
Area of Science:
- Oncology
- Palliative Care
- Gastroenterology
Background:
- The World Health Organization (WHO) recommends morphine as a first-line strong opioid for managing cancer pain.
- Opioid analgesics, including morphine, are known to cause gastrointestinal side effects, primarily constipation.
- Effective pain management is crucial for improving the quality of life in terminally ill cancer patients.
Observation:
- A case of intestinal pseudo-obstruction was observed in a terminally ill cancer patient.
- The patient was receiving oral morphine for cancer pain management.
- Gastro-intestinal transit delay was a significant clinical feature.
Findings:
- Oral morphine use can lead to severe constipation.
- Intestinal pseudo-obstruction is a potential, albeit rare, complication of oral morphine therapy in cancer patients.
- This condition can mimic an acute abdomen, necessitating careful differential diagnosis.
Implications:
- Clinicians should be vigilant for signs of intestinal pseudo-obstruction in cancer patients on oral morphine.
- Early recognition and management of opioid-induced constipation are vital to prevent serious complications.
- Alternative pain management strategies or bowel regimen adjustments may be necessary for patients experiencing severe gastrointestinal dysfunction.