![]() The most common regime for OIC is a stimulant (senna/bisacodyl) with or without a stool softener (docusate), or daily administration of an osmotic laxative (polyethylene glycol). While most laxatives can work to relieve constipation, bulk-forming laxatives like psyllium should be avoided. Patients with predisposing factors (immobility, advanced age, poor diet, intra-abdominal pathology, neuropathy, concurrent use of other constipating drugs) are specifically indicated. Use of manual measures (digital evacuation and/or support of the pelvic floor) to help move or remove the stools from the rectumĪll healthcare professionals prescribing opioids need to also consider prophylactic laxative therapy for constipation.A sensation of incomplete evacuation in at least 25 percent of defecations.Straining in at least 25 percent of defecation.Hard stools in at least 25 percent of defecations.The Rome IV criteria for functional constipation includes at least two of following for a period of at least 3 months: Characterizing a patient as constipated cannot be based solely on the number of bowel movements per day, or week, but rather as a function of their normal regularity. Opiate-Induced Constipationįunctional constipation is broadly defined as the difficult passage of hard, dry stool, less frequently than the patient’s typical pattern of bowel movements. Opiate receptors in the gastrointestinal tract reduce motility and increase transit time, and the resulting increased absorption of fluid by the intestinal tract leads to hardening of stool and constipation. Opiates’ effects on gastrointestinal motility have long been recognized by the medical community, and Opioid-induced constipation (OIC) accounts for forty to sixty percent of cases in non-cancer patients (for cancer patients this percentage is as high as 90%) receiving opioids. Forty to eighty percent of patients taking opioids over a longer period of time struggle with constipation and need to have an effective bowel management program for managing constipation as a result. It is widely known that opioid pain medications have constipation as a common side effect. ![]() A recent study showed that around 15% of American adults take more than the recommended dosage when attempting to relieve pain. It is less known, however, that NSAIDs can also cause constipation, particularly when taken in higher-than-recommended doses. People generally know that NSAIDs can cause gastrointestinal distress, like bleeding and ulcers. ![]() Acetaminophen can have other gastrointestinal problems as a side effect as well, such as nausea and vomiting, which were reported more frequently than constipation. Up to 10% of people taking acetaminophen in therapeutic doses reported constipation as a side effect. While Acetaminophen can cause constipation, it is less likely to do so than either opioid medications or NSAIDS. Out of the three, opioid medications tend to cause more severe constipation. All three medications come with constipation as a potential side effect. Non-Steroidal Anti-Inflammatory Drugs (NSAIDs), acetaminophen and opioid pain medications are the most common medications utilized for pain relief. ![]() There are several variables that determine the severity of constipation and need to monitor dosage including age, comorbid conditions, drug interactions, and genetics. Pain medications are widely used for treatment of both chronic and acute pain, but they come with a common side effect: constipation. ![]()
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