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Nelson AD, Camilleri M. Opioid-induced constipation: advances and clinical guidance. Ther Adv Chronic Dis. 2016;7(2):121-34doi: 10.1177/2040622315627801.
Nelson, A. D., & Camilleri, M. (2016). Opioid-induced constipation: advances and clinical guidance. Therapeutic advances in chronic disease, 7(2), 121-34. https://doi.org/10.1177/2040622315627801
Nelson, Alfred D, and Camilleri, Michael. "Opioid-induced constipation: advances and clinical guidance." Therapeutic advances in chronic disease vol. 7,2 (2016): 121-34. doi: https://doi.org/10.1177/2040622315627801
Nelson AD, Camilleri M. Opioid-induced constipation: advances and clinical guidance. Ther Adv Chronic Dis. 2016 Mar;7(2):121-34. doi: 10.1177/2040622315627801. Epub 2016 Jan 25. PMID: 26977281; PMCID: PMC4772344.
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Ther Adv Chronic Dis. 2016 Mar;7(2):121-34. doi: 10.1177/2040622315627801. Epub 2016 Jan 25.

Opioid-induced constipation: advances and clinical guidance.

Therapeutic advances in chronic disease

Alfred D Nelson, Michael Camilleri

Affiliations

  1. Clinical Enteric Neuroscience Translational and Epidemiological Research (CENTER), Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, MN, USA.
  2. Clinical Enteric Neuroscience Translational and Epidemiological Research (CENTER), Division of Gastroenterology and Hepatology, Mayo Clinic, Charlton Building, Room 8-110, 200 First Street SW, Rochester, MN 55905, USA.

PMID: 26977281 PMCID: PMC4772344 DOI: 10.1177/2040622315627801

Abstract

Currently opioids are the most frequently used medications for chronic noncancer pain. Opioid-induced constipation is the most common adverse effect associated with prolonged use of opioids, having a major impact on quality of life. There is an increasing need to treat opioid-induced constipation. With the recent approval of medications for the treatment of opioid-induced constipation, there are several therapeutic approaches. This review addresses the clinical presentation and diagnosis of opioid-induced constipation, barriers to its diagnosis, effects of opioids in the gastrointestinal tract, differential tolerance to opiates in different gastrointestinal organs, medications approved and in development for the treatment of opioid-induced constipation, and a proposed clinical management algorithm for treating opioid-induced constipation in patients with noncancer pain.

Keywords: lubiprostone; methylnaltrexone; naloxegol; noncancer pain; peripheral ยต opioid receptor antagonist; tolerance

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