• Curr Gastroenterol Rep · Oct 2014

    Review

    Narcotic bowel syndrome and opioid-induced constipation.

    • Eva Szigethy, Marc Schwartz, and Douglas Drossman.
    • Department of Psychiatry, University of Pittsburgh, Medical Arts Building, 3708 Fifth Ave, Pittsburgh, PA, 15213, USA, szigethye@upmc.edu.
    • Curr Gastroenterol Rep. 2014 Oct 1;16(10):410.

    AbstractPrescription opioid use for chronic non-cancer pain has reached epidemic levels in the USA. With this increased use is the recognition of serious opioid-related gastrointestinal complications such as narcotic bowel syndrome (NBS) and opioid-induced constipation (OIC). NBS consists of a paradoxical worsening of abdominal pain with escalating doses of opioids and is likely mediated by the central nervous system. Therapy requires an intensive multidisciplinary approach to detoxification. OIC is the most common gastrointestinal side effect of opioids. Several novel therapeutics are available to treat OIC that fails to respond to laxative therapy. This review will summarize recent findings on the pathophysiology and treatment approaches to NBS and OIC with a focus on controversies about diagnosis and intervention.

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