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[Opioid-induced bowel dysfunction: a literature analysis on pathophysiology and treatment].

Abstract
Bowel dysfunction is a frequent and serious side effect of opioid analgetics. In spite of its common occurrence, in the course of clinical routine, it is frequently ignored or underestimated. Authors of the analysed literature widely agree that a prophylactic and routine pharmacotherapy is necessary. For this purpose, laxatives, enemas and suppositories, prokinetic agents and opioid antagonists can be considered. Bulk-forming laxatives did not prove to be effective, since the quantity of fluid intake required for the action usually cannot be provided. Furthermore, the benefit of emollient agents is doubted. As a monotherapy they are not sufficient. By contrast, stimulant and osmotic laxatives proved to be active. Prokinetic drugs are not recommended because of their serious side effects. Effective abatement of opioid-induced obstipation by opioid antagonists has been proven in numerous studies. However, the loss of analgesia and opioid withdrawal symptoms were described as adverse effects. Development of quaternary opioid antagonists such as methylnaltrexone was allowed for mitigating these adverse effects.
AuthorsJürgen Osterbrink, Ute Haas
JournalWiener medizinische Wochenschrift (1946) (Wien Med Wochenschr) Vol. 158 Issue 21-22 Pg. 621-6 ( 2008) ISSN: 0043-5341 [Print] Austria
Vernacular TitleOpioidinduzierte Obstipation: Literaturanalyse zu Pathophysiologie und Behandlung.
PMID19052708 (Publication Type: Comparative Study, English Abstract, Journal Article, Review)
Chemical References
  • Analgesics, Opioid
  • Laxatives
  • Narcotic Antagonists
Topics
  • Acupuncture
  • Analgesics, Opioid (adverse effects)
  • Constipation (chemically induced, complications, drug therapy, physiopathology, therapy)
  • Enema
  • Fluid Therapy
  • Humans
  • Laxatives (administration & dosage, adverse effects, therapeutic use)
  • Massage
  • Narcotic Antagonists (administration & dosage, therapeutic use)
  • PubMed
  • Randomized Controlled Trials as Topic
  • Surveys and Questionnaires

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