Zeitschrift für fortgeschrittene Praktiken in der Krankenpflege

Treatment of Opioid-induced Constipation: A Therapeutic Update

Abstract

Zdanowicz MM

Opioids remain the most effective therapeutic agents for the management of moderate to severe pain. A significant number of patients receive long-term opioid therapy for chronic pain. While a number of opioid side effects such as sedation, nausea and vomiting, and respiratory depression diminish over time due to the development of tolerance, the constipating effects of opioid persist throughout the course of therapy. Opioid-induced constipation (OIC) is associated with marked bowel dysfunction that can significantly impact a patient’s quality of life and affect their drug adherence. A step-wise approach to treating OIC should be considered which includes life style modifications, administration of laxatives and stool-softeners, and if necessary, pharmacologic agents to enhance bowel motility and antagonize peripheral μ-opioid receptors. Although OIC is a significant adverse effect associated with opioid use, clinical studies have shown that a number of effective treatment strategies are available for both preventing OIC or reducing its severity.