Current concepts in the management of opioid-induced constipation

John Brandon Walters, MD; Marcos Montagnini, MD, FACP

doi:10.5055/jom.2010.0042

Authors

John Brandon Walters, MD
Marcos Montagnini, MD, FACP

DOI:

https://doi.org/10.5055/jom.2010.0042

Keywords:

constipation, laxatives, symptom management

Abstract

Patients with chronic pain on daily opioid therapy are frequently burdened with symptoms of constipation. Opioid-induced constipation (OIC) contributes to an overall negative impact on the quality of life and may result in poor pain management outcomes. Laxative agents are crucial in opioid-related pain management. Following a careful assessment, a stepwise approach to OIC may provide comfort and relief to patients. This article reviews the pathophysiology, assessment, and pharmacological treatment of OIC. Novel approaches for OIC such as the peripheral opioid receptor antagonists and selective serotonin antagonists are also discussed.

Author Biographies

John Brandon Walters, MD

Hospice of the Western Reserve, Cleveland, Ohio.

Marcos Montagnini, MD, FACP

VA Ann Arbor Healthcare System, University of Michigan Healthcare System, Ann Arbor, Michigan; Associate Professor, Division of Geriatric Medicine, University of Michigan, Ann Arbor, Michigan.

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