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Br J Nurs. 2016 May 26-Jun 8;25(10):S4-5, S8-11. doi: 10.12968/bjon.2016.25.10.S4.

Management of opioid-induced constipation.

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Senior Associate Consultant, Division of Gastroenterology, Mayo Clinic Health System La Crosse, Wisconsin, USA.
Professor of Clinical Nursing Practice Research, Florence Nightingale Foundation, King's College London, UK.
Professor of Medicine, Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, Minnesota, USA.


Up to 40% of patients taking opioids develop constipation. Opioid-induced constipation (OIC) may limit the adequate dosing of opioids for pain relief and reduce quality of life. Health professionals must therefore inquire about bowel function in patients receiving opioids. The management of OIC includes carefully re-evaluating the necessity, type and dose of opioids at each visit. Lifestyle modification and alteration of aggravating factors, the use of simple laxatives and, when essential, the addition of newer laxatives or opioid antagonists (naloxone, naloxegol or methylnaltrexone) can be used to treat OIC. This review discusses the recent literature regarding the management of OIC and provides a rational approach to assessing and managing constipation in individuals receiving opioids.


Chronic pain; Constipation; Laxatives; Methylnaltrexone; Naloxegol; Naloxone; Opioids

[Indexed for MEDLINE]

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