• Pain Med · Oct 2015

    Review

    Opioid-Induced Constipation.

    • Lynn R Webster.
    • Vice President of Scientific Affairs, PRA Health Sciences, Salt Lake City, Utah, USA.
    • Pain Med. 2015 Oct 1; 16 Suppl 1: S16-21.

    IntroductionOpioid-induced constipation (OIC) is common in people treated with opioids and poses risks for physical sequelae, analgesic discontinuation, and decreased quality of life.MethodsTargeted literature review of evidence- and consensus-based data on appropriate diagnosis, concise definition, and conventional and newer management strategies for OIC.ResultsOIC may develop early and need early treatment. To address gaps in consistent definitions and treatment recommendations, a consensus panel organized through the American Academy of Pain Medicine Foundation set diagnostic criteria and endorsed the Bowel Function Index for OIC assessment. The panel further proposed management strategies for OIC, including a proposed threshold for prescriptive therapies.DiscussionOIC results from action exerted on opioid receptors in the gastrointestinal tract, a mechanism distinct from idiopathic constipation. Lifestyle changes and over-the-counter drugs are first-line treatments but leave refractory constipation in many opioid-treated patients. Newer therapeutic modalities that are available and in development are highlighted.SummaryPhysicians need a better understanding of the negative impacts of OIC for patients and better OIC-specific methods to assess, treat, and monitor it.Wiley Periodicals, Inc.

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