[Analysis of the European Consensus on the treatment of opioid-induced constipation analgesic drugs.]

Abstract

Until recently, conclusive data on clinical presentation, diagnosis and therapy of the opioid-induced constipation (OIC) were not available. Lately, some phase II and III prospective studies, evaluating the efficay of several old and new laxatives in cancer and non-cancer patients, make their mechanisms of action easier to understand and lead healthcare institutions to determine homogeneous guidelines for OIC, with the use of diagnostic and treatment algorithms. On May 2018, management recommendations from a panel of 7 European experts on OIC was published on United European Gastroenterology Journal. They discussed on different aspects of OIC: (a) definitions and diagnostic criteria; (b) pathophysiology; (c) clinical evaluation; (d) patient reported outcome measures; (e) initial standard laxatives; (f) specific treatments; (g) pragmatic recommendations. Later, a multi-disciplinary panel consisting of experts in neurogastroenterology, oncology and palliative medicine gave their external input. This statement will help clinicians to harmoniously treat OIC, according to clear guidelines, resulted from phase II and III prospective studies. Nevertheless, the constipation is rarely due to opioids consumption alone. More often, different factors contribute to induce constipation, including diet, immobility, other drugs, pain during evacuation, comorbidities, gastrointestinal obstacles, especially in advanced cancer patients. Therefore, management of OIC always needs to be tailored to the individual patient based on their overall clinical picture.

• Authors: Pina Tiziana Falbo, Vittore Cereda, Gaia Manna, Alessandro Iannace, Antonello Menghi, Michela Corona, Gaetano Lanzetta
• Journal: Recenti progressi in medicina (Recenti Prog Med) 2019 Jul-Aug Vol. 110 Issue 7 Pg. 338-342 ISSN: 2038-1840 [Electronic] Italy
• Vernacular Title: Analisi del consensus europeo sul trattamento della stipsi indotta da farmaci analgesici oppiacei.
• PMID: 31379368 (Publication Type: Journal Article, Review)

Chemical References

• Analgesics, Opioid
• Laxatives

Topics

• Analgesics, Opioid (administration & dosage, adverse effects)
• Humans
• Laxatives (administration & dosage)
• Neoplasms (drug therapy)
• Opioid-Induced Constipation (diagnosis, drug therapy)
• Practice Guidelines as Topic
• Risk Factors