A review of the clinical manifestations, pathophysiology and management of opioid bowel dysfunction and narcotic bowel syndrome.
Opioids are widely used for the treatment of malignant and non-malignant pains. These medications are accompanied by adverse effects, in particular gastrointestinal symptoms known as opioid bowel dysfunction (OBD). The most common symptom of OBD is refractory constipation that is usually stable regardless of the use of laxatives. Narcotic bowel syndrome (NBS) is a subset of OBD described as ambiguous chronic pain aggravated by continual or increased opioid use for pain relief. Pathophysiology of these disorders are not definitely disentangled. Some challenging hypothesis have been posed leading to specific management in order to mitigate the adverse effects. This article is a review of the literature on the prevalence, pathophysiology and management of OBD and NBS.
Iran University of Medical Sciences, Tehran, Iran.
Zahra
Z
Azizi
Tehran University of Medical Sciences, Tehran, Iran.
Sanam
S
Javid Anbardan
Department of Internal Medicine, Division of Gastroenterology, Imam Khomeini Hospital, Tehran University of Medical Sciences, Tehran, Iran.
Naser
N
Ebrahimi Daryani
Constipation; Narcotic bowel syndrome; Opioid; Opioid bowel dysfunction; Pain