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2014 ; 26
(10
): 1386-95
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Emerging treatments in neurogastroenterology: a multidisciplinary working group
consensus statement on opioid-induced constipation
#MMPMID25164154
Camilleri M
; Drossman DA
; Becker G
; Webster LR
; Davies AN
; Mawe GM
Neurogastroenterol Motil
2014[Oct]; 26
(10
): 1386-95
PMID25164154
show ga
BACKGROUND: Opioids are effective for acute and chronic pain conditions, but
their use is associated with often difficult-to-manage constipation and other
gastrointestinal (GI) effects due to effects on peripheral ?-opioid receptors in
the gut. The mechanism of opioid-induced constipation (OIC) differs from that of
functional constipation (FC), and OIC may not respond as well to most first-line
treatments for FC. The impact of OIC on quality of life (QoL) induces some
patients to decrease or stop their opioid therapy to relieve or avoid
constipation. PURPOSE: At a roundtable meeting on OIC, a working group developed
a consensus definition for OIC diagnosis across disciplines and reviewed current
OIC treatments and the potential of treatments in development. By consensus, OIC
is defined as follows: 'A change when initiating opioid therapy from baseline
bowel habits that is characterized by any of the following: reduced bowel
movement frequency, development or worsening of straining to pass bowel
movements, a sense of incomplete rectal evacuation, or harder stool consistency'.
The working group noted the prior validation of a patient response outcome and
end point for clinical trials and recommended future efforts to create treatment
guidelines and QoL measures specific for OIC. Details from the working group's
discussion and consensus recommendations for patient care and research are
presented in this article.
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