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Emerging treatments in neurogastroenterology: a multidisciplinary working group consensus statement on opioid‐induced constipation
Author(s) -
Camilleri M.,
Drossman D. A.,
Becker G.,
Webster L. R.,
Davies A. N.,
Mawe G. M.
Publication year - 2014
Publication title -
neurogastroenterology and motility
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.489
H-Index - 105
eISSN - 1365-2982
pISSN - 1350-1925
DOI - 10.1111/nmo.12417
Subject(s) - constipation , medicine , opioid , functional constipation , quality of life (healthcare) , irritable bowel syndrome , functional gastrointestinal disorder , intensive care medicine , physical therapy , nursing , receptor
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 μ ‐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.