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Pathophysiology and management of opioid‐induced constipation: European expert consensus statement
- Source :
- Farmer, A D, Drewes, A, Chiarioni, G, De Giorgio, R, O’Brien, T, Morlion, B & Tack, J 2019, ' Pathophysiology and management of opioid-induced constipation : European expert consensus statement ', United European Gastroenterology Journal, vol. 7, no. 1, pp. 7-20 . https://doi.org/10.1177/2050640618818305
- Publication Year :
- 2019
- Publisher :
- Wiley, 2019.
-
Abstract
- Background: Opioid-induced bowel dysfunction is a complication of opioid therapy, in which constipation is the most common and problematic symptom. However, it is frequently under-recognised and thus effective management is often not instituted despite a number of treatment options. Objective: The central objective of this study is to provide a summary of the pathophysiology and clinical evaluation of opioid-induced constipation and to provide a pragmatic management algorithm for day-to-day clinical practice. Methods: This summary and the treatment algorithm is based on the opinion of a European expert panel evaluating current evidence in the literature. Results: The pathophysiology of opioid-induced constipation is multi-faceted. The key aspect of managing opioid-induced constipation is early recognition. Specific management includes increasing fluid intake, exercise and standard laxatives as well as addressing exacerbating factors. The Bowel Function Index is a useful way of objectively evaluating severity of opioid-induced constipation and monitoring response. Second-line treatments can be considered in those with recalcitrant symptoms, which include gut-restricted or peripherally acting mu-opioid receptor antagonists. However, a combination of interventions may be needed. Conclusion: Opioid-induced constipation is a common, yet under-recognised and undertreated, complication of opioid therapy. We provide a pragmatic step-wise approach to opioid-induced constipation, which should simplify management for clinicians. ispartof: United European Gastroenterology Journal vol:7 issue:1 pages:7-20 ispartof: location:England status: published
- Subjects :
- medicine.medical_specialty
Constipation
Statement (logic)
gastroenterology
gastro-intestinal motility
management algorithm
NO
03 medical and health sciences
0302 clinical medicine
Medicine
Intensive care medicine
Review Articles
bowel dysfunction
Opioid-induced constipation
business.industry
Gastroenterology
Expert consensus
Pathophysiology
Bowel dysfunction
Opioid induced constipation
Oncology
Opioid
030220 oncology & carcinogenesis
030211 gastroenterology & hepatology
medicine.symptom
business
Complication
medicine.drug
Subjects
Details
- ISSN :
- 20506414 and 20506406
- Volume :
- 7
- Database :
- OpenAIRE
- Journal :
- United European Gastroenterology Journal
- Accession number :
- edsair.doi.dedup.....a056e3922d4c2bc7e566ee56cf623d54
- Full Text :
- https://doi.org/10.1177/2050640618818305