Restoring Balance: Advances in the Management of Opioid-Induced Constipation
Introduction to Opioid-Induced Constipation
Fecal incontinence in the elderly.
Leung FW, et al. Gastroenterol Clin North Am. 2009
Opioid-induced constipation in patients with chronic noncancer pain in the USA, Canada, Germany, and the UK: descriptive analysis of baseline patient-reported outcomes and retrospective chart review.
Coyne KS, et al. Clinicoecon Outcomes Res. 2014;6:269-281.
Opioids in chronic non-cancer pain: systematic review of efficacy and safety.
Kalso E, et al. Pain. 2004;112(3):372-380
Constipation in people prescribed opioids.
Ahmedzai SH, Boland J. Clin Evid (Online). 2010;pii:2407
A multi-institutional study analyzing effect of prophylactic medication for prevention of opioid-induced gastrointestinal dysfunction.
Ishihara M, et al. Clin J Pain. 2012;28(5):373-381.
A volunteer model for the comparison of laxatives in opioid-related constipation.
Sykes NP. J Pain Symptom Manage. 1996;11(6):363-369.
A Randomized Study of Lubiprostone for Opioid-Induced Constipation in Patients with Chronic Noncancer Pain.
Cryer B, et al. Pain Med. 2014; Epublished ahead of print.
Naloxegol for opioid-induced constipation in patients with noncancer pain.
Chey WD, et al. N Engl J Med. 2014;370:2387-2396.
Patient preference with respect to QoL and reduction in opioid-induced constipation (OIC) after treatment with prolonged-release (PR) oxycodone/naloxone compared with previous analgesic therapy [PREFER study].
van Dongen VC, et al. Int J Clin Pract. 2014. Epublished ahead of print.
Clinical Tools
Bowel Function Index
The BFI provides a numerical assessment score for prior 7 days based on ease of defecation, feeling of incomplete evacuation, and personal judgment of constipation.
Patient Assessment of Constipation (PAC-SYM)
This 12-item questionnaire of patient-reported symptoms assesses 3 subscales of symptoms (bowel movements, rectal symptoms, and abdominal symptoms) over the 2 prior weeks.
Bristol Stool Form Scale
This visual scale is used to classify the type of stools passed.
Patient Education Tool
This patient education tool list items that patients can do at home to help ease their opioid-induced constipation and includes a list of questions to ask the doctor or clinic about constipation.
Guidelines
The functional gastrointestinal disorders and the Rome III process, 2006.
Drossman DA. Gastroenterology. 2006;130:1377-1390.
Clinical guidelines for the use of chronic opioid therapy in chronic noncancer pain.
Chou R, et al. Pain. 2009;10(2):113-130.
Clinical practice guidelines: Management of Opioid Therapy for Chronic Pain, 2010
Department of Veterans Affairs. VA/DOD Clinical Practice Guideline for Management of Opioid Therapy for Chronic Pain.
Other Resources
A Clinical Guide to Opioid Analgesia. 2nd edition
Fine PG, Portenoy RK. New York, NY: Vendome Group, LLC; 2007.
Responsible Opioid Prescribing: A Clinician’s Guide. 2nd edition, revised and expanded
Fishman SM. Washington, DC: Waterford Life Sciences; 2012.
Advances in the Management of Opioid-Induced Constipation
Restoring Balance
| Faculty: | Jeffrey Gudin, MD; Anthony Lembo, MD; Bill McCarberg, MD |
| Release: | 12/15/2014 |
| Expiration: | 12/15/2015 |
