Opioid-Induced Constipation and Bowel Dysfunction: A Clinical Guideline.


eMediNexus Editorial    30 December 2017

Constipation is a major adverse effect of opioids. Increasing prescription of opioids has been linked to higher incidence of opioid-induced constipation.

The aim of a recent study published in Pain Medicine was to formulate timely evidence-based guidelines for the management of opioid-induced bowel dysfunction.

Here, a literature search was conducted on Medline, EMBASE, and EMBASE Classic, and the Cochrane Central Register of Controlled Trials.

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.

Hence, it was inferred that in recent years, more insight has been gained in the pathophysiology of this opioid-induced bowel dysfunction. It was stated that new treatment approaches have been developed, however, guidelines on clinical best practice are lacking. It was thus, concluded that the current knowledge is insufficient regarding management of the opioid side effects on the upper gastrointestinal tract, but recommendations can be derived from the existing data.1


  1. Müller-Lissner S, Bassotti G, Coffin B et al. Opioid-Induced Constipation and Bowel Dysfunction: A Clinical Guideline. Pain Medicine. 2016:pnw255. doi:10.1093/pm/pnw255.

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