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Opioid-Induced Constipation and Bowel Dysfunction: A Clinical Guideline
OBJECTIVE: To formulate timely evidence-based guidelines for the management of opioid-induced bowel dysfunction. SETTING: Constipation is a major untoward effect of opioids. Increasing prescription of opioids has correlated to increased incidence of opioid-induced constipation. However, the inhibito...
Autores principales: | , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Oxford University Press
2017
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5914368/ https://www.ncbi.nlm.nih.gov/pubmed/28034973 http://dx.doi.org/10.1093/pm/pnw255 |
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author | Müller-Lissner, Stefan Bassotti, Gabrio Coffin, Benoit Drewes, Asbjørn Mohr Breivik, Harald Eisenberg, Elon Emmanuel, Anton Laroche, Françoise Meissner, Winfried Morlion, Bart |
author_facet | Müller-Lissner, Stefan Bassotti, Gabrio Coffin, Benoit Drewes, Asbjørn Mohr Breivik, Harald Eisenberg, Elon Emmanuel, Anton Laroche, Françoise Meissner, Winfried Morlion, Bart |
author_sort | Müller-Lissner, Stefan |
collection | PubMed |
description | OBJECTIVE: To formulate timely evidence-based guidelines for the management of opioid-induced bowel dysfunction. SETTING: Constipation is a major untoward effect of opioids. Increasing prescription of opioids has correlated to increased incidence of opioid-induced constipation. However, the inhibitory effects of opioids are not confined to the colon, but also affect higher segments of the gastrointestinal tract, leading to the coining of the term “opioid-induced bowel dysfunction.” METHODS: A literature search was conducted using Medline, EMBASE, and EMBASE Classic, and the Cochrane Central Register of Controlled Trials. Predefined search terms and inclusion/exclusion criteria were used to identify and categorize relevant papers. A series of statements were formulated and justified by a comment, then labeled with the degree of agreement and their level of evidence as judged by the Strength of Recommendation Taxonomy (SORT) system. RESULTS: From a list of 10,832 potentially relevant studies, 33 citations were identified for review. Screening the reference lists of the pertinent papers identified additional publications. Current definitions, prevalence, and mechanism of opioid-induced bowel dysfunction were reviewed, and a treatment algorithm and statements regarding patient management were developed to provide guidance on clinical best practice in the management of patients with opioid-induced constipation and opioid-induced bowel dysfunction. CONCLUSIONS: In recent years, more insight has been gained in the pathophysiology of this “entity”; new treatment approaches have been developed, but guidelines on clinical best practice are still lacking. Current knowledge is insufficient regarding management of the opioid side effects on the upper gastrointestinal tract, but recommendations can be derived from what we know at present. |
format | Online Article Text |
id | pubmed-5914368 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2017 |
publisher | Oxford University Press |
record_format | MEDLINE/PubMed |
spelling | pubmed-59143682018-05-04 Opioid-Induced Constipation and Bowel Dysfunction: A Clinical Guideline Müller-Lissner, Stefan Bassotti, Gabrio Coffin, Benoit Drewes, Asbjørn Mohr Breivik, Harald Eisenberg, Elon Emmanuel, Anton Laroche, Françoise Meissner, Winfried Morlion, Bart Pain Med GENERAL SECTION OBJECTIVE: To formulate timely evidence-based guidelines for the management of opioid-induced bowel dysfunction. SETTING: Constipation is a major untoward effect of opioids. Increasing prescription of opioids has correlated to increased incidence of opioid-induced constipation. However, the inhibitory effects of opioids are not confined to the colon, but also affect higher segments of the gastrointestinal tract, leading to the coining of the term “opioid-induced bowel dysfunction.” METHODS: A literature search was conducted using Medline, EMBASE, and EMBASE Classic, and the Cochrane Central Register of Controlled Trials. Predefined search terms and inclusion/exclusion criteria were used to identify and categorize relevant papers. A series of statements were formulated and justified by a comment, then labeled with the degree of agreement and their level of evidence as judged by the Strength of Recommendation Taxonomy (SORT) system. RESULTS: From a list of 10,832 potentially relevant studies, 33 citations were identified for review. Screening the reference lists of the pertinent papers identified additional publications. Current definitions, prevalence, and mechanism of opioid-induced bowel dysfunction were reviewed, and a treatment algorithm and statements regarding patient management were developed to provide guidance on clinical best practice in the management of patients with opioid-induced constipation and opioid-induced bowel dysfunction. CONCLUSIONS: In recent years, more insight has been gained in the pathophysiology of this “entity”; new treatment approaches have been developed, but guidelines on clinical best practice are still lacking. Current knowledge is insufficient regarding management of the opioid side effects on the upper gastrointestinal tract, but recommendations can be derived from what we know at present. Oxford University Press 2017-10 2016-12-15 /pmc/articles/PMC5914368/ /pubmed/28034973 http://dx.doi.org/10.1093/pm/pnw255 Text en © 2016 American Academy of Pain Medicine. This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/), which permits non-commercial re-use, distribution, and reproduction in any medium, provided the original work is properly cited. For commercial re-use, please contact journals.permissions@oup.com |
spellingShingle | GENERAL SECTION Müller-Lissner, Stefan Bassotti, Gabrio Coffin, Benoit Drewes, Asbjørn Mohr Breivik, Harald Eisenberg, Elon Emmanuel, Anton Laroche, Françoise Meissner, Winfried Morlion, Bart Opioid-Induced Constipation and Bowel Dysfunction: A Clinical Guideline |
title | Opioid-Induced Constipation and Bowel Dysfunction: A Clinical Guideline |
title_full | Opioid-Induced Constipation and Bowel Dysfunction: A Clinical Guideline |
title_fullStr | Opioid-Induced Constipation and Bowel Dysfunction: A Clinical Guideline |
title_full_unstemmed | Opioid-Induced Constipation and Bowel Dysfunction: A Clinical Guideline |
title_short | Opioid-Induced Constipation and Bowel Dysfunction: A Clinical Guideline |
title_sort | opioid-induced constipation and bowel dysfunction: a clinical guideline |
topic | GENERAL SECTION |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5914368/ https://www.ncbi.nlm.nih.gov/pubmed/28034973 http://dx.doi.org/10.1093/pm/pnw255 |
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