What are the current standards of care or guidelines in opioid-induced constipation (OIC)?

Knowledge Library published on June 21, 2013 in Practice
Download Transcript Download Audio
Jeffrey A. Gudin, MD
Director
Pain Management Center
Englewood Hospital and Medical Center
Englewood, New Jersey
This is Dr. Jeff Gudin, I am a pain management anesthesiologist and palliative care specialist at the Englewood Hospital and Medical Center in Englewood, New Jersey. I am often asked if there are any standards of care or guidelines for the treatment of opioid-induced constipation. And it turns out that this problem, although it has been recognized for decades, has really only been targeted by the pharmaceutical industry for just the past few years. We have some novel agents available to us, as you will see in our educational program, things like opioid receptor antagonists that work only out in the periphery, and even some newer agents that work by modulating ion channels at the level of the gut to draw more fluid, more water, into the intestine, stimulate motility and lubricate the stool. So although we do not have any set standards by our pain or GI societies, really what I tell clinicians is that you should try to match the appropriate therapy to the underlying disorder. So patients who take opioids obviously get what is called OIC or opioid-induced constipation. There is no one simple and easy answer. As you will see from our educational program, there are things like dietary modification, behavioral modification, activity modification, things like exercise. In addition to a host of new agents that are available, including the class of opioid receptor antagonist and chloride and ion channel activators, to again promote more flow of fluid into the bowel. When we think about opioid-induced constipation, we like to think about an overall treatment plan which incorporates not just drug therapy, but also some of those other non-drug therapies as well.
Last modified: June 7, 2013
Related Items by Category
Will patients build a tolerance to opioid-induced constipation (OIC) over time?
Knowledge Library published on July 19, 2013 in Practice
What are some of the risk factors for developing opioid-induced constipation (OIC)?
Knowledge Library published on July 12, 2013 in Practice
Do the new agents for opioid-induced constipation (OIC) have any adverse effects?
Knowledge Library published on June 28, 2013 in Practice
How do you assess opioid-induced constipation (OIC)?
Knowledge Library published on June 14, 2013 in Practice
Can these PDMPs be accessed across states?
Knowledge Library published on May 24, 2013 in Practice
Are all the PDMPs operationally the same?
Knowledge Library published on May 10, 2013 in Practice
Should everyone have a treatment agreement regardless of their assessed risk level?
Knowledge Library published on May 3, 2013 in Practice
When a patient displays aberrant behaviors, should clinicians assume they are abusing their opioid?
Knowledge Library published on April 26, 2013 in Practice
How often should the database be accessed? After each prescription or periodically?
Knowledge Library published on April 12, 2013 in Practice
What about the chronic pain patient who is hospitalized for some acute event or episode?
Knowledge Library published on April 5, 2013 in Practice
Related Items by Author
Will patients build a tolerance to opioid-induced constipation (OIC) over time?
Jeffrey A. Gudin, MD
Knowledge Library published on July 19, 2013 in Practice
Do the new agents for opioid-induced constipation (OIC) have any adverse effects?
Jeffrey A. Gudin, MD
Knowledge Library published on June 28, 2013 in Practice