Diagnosis and management of opioid-induced bowel dysfunction in patients with advanced cancer

Opioid-induced bowel dysfunction (OBD) is characterized by a constellation of symptoms, including constipation; dry, hard stools; strain- ing; and incomplete evacuation. The use of a prophylactic bowel regimen that includes a stimulant laxative and stool softener generally is accepted and should be initiated at the start of opioid therapy. Effective prevention and treatment of OBD reduce the risk of associated physiologic complications and can improve pain management and quality of life for patients and their families.