title: Management of opioid-induced constipation.
abstract: Up to 40% of patients taking opioids develop constipation. Opioid-induced constipation (OIC) may limit the adequate dosing of opioids for pain relief and reduce quality of life. Health professionals must therefore inquire about bowel function in patients receiving opioids. The management of OIC includes carefully re-evaluating the necessity, type and dose of opioids at each visit. Lifestyle modification and alteration of aggravating factors, the use of simple laxatives and, when essential, the addition of newer laxatives or opioid antagonists (naloxone, naloxegol or methylnaltrexone) can be used to treat OIC. This review discusses the recent literature regarding the management of OIC and provides a rational approach to assessing and managing constipation in individuals receiving opioids.
authors.affiliation: Senior Associate Consultant, Division of Gastroenterology, Mayo Clinic Health System La Crosse, Wisconsin, USA.
authors.forename: David
authors.initials: D
authors.lastname: Prichard
authors.affiliation: Professor of Clinical Nursing Practice Research, Florence Nightingale Foundation, King's College London, UK.
authors.forename: Christine
authors.initials: C
authors.lastname: Norton
authors.affiliation: Professor of Medicine, Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, Minnesota, USA.
authors.forename: Adil E
authors.initials: AE
authors.lastname: Bharucha
mesh_terms: D000701:Analgesics, Opioid / Q000009:adverse effects*; D059350:Chronic Pain / Q000188:drug therapy*; D003248:Constipation / Q000139:chemically induced / Q000517:prevention & control* / Q000628:therapy; D019468:Disease Management; D004733:Enema; D005440:Fluid Therapy; D006801:Humans; D054368:Laxatives / Q000627:therapeutic use*; D009292:Narcotic Antagonists / Q000627:therapeutic use*
chemical_list: D000701:Analgesics, Opioid; D054368:Laxatives; D009292:Narcotic Antagonists
keywords: Chronic pain; Constipation; Laxatives; Methylnaltrexone; Naloxegol; Naloxone; Opioids