Jose G. Veliz, M.D. M.S.A.
Medical Director
Palomar Pain Management Center
Pomerado Pain Management Center

Posted February 1, 2009 8:23 AM

The use of opioids can commonly lead to constipation, bloating, and increased acid reflux. This is secondary to incomplete emptying and dysfunction of the bowel. The definition of constipation includes, the evacuation of hard stools less frequently than is normal for the individual or as a symptom characterized by diminished frequency of defecation associated with difficulty or discomfort. Gastrointestinal discomfort is one of the side effects of opioids which usually does not resolve with time. For this reason, it is important to eat diets which are high in fiber and to use stool softeners with chronic use of opioids. Studies are currently being performed on drugs which can act locally in the gut to reverse the gastrointestinal dysfunction secondary to opioids without reversing analgesia.

References:

Dickerson E D, Benedetti, C, Davis, M P, et al. Palliative Care Pocket Consultant. Columbus, OH; Janoski Advertising Design; 1999.

Portnoy R K. Management of Common Opioid Side Effects during Long Term Therapy of Cancer Pain. Ann ACAD MED Singapore 1994; 23:160-70.

McNicoll E, et al. Efficacy and Safety of Mu-Opioid Antagonists in the Treatment of Opioid-Induced Bowel Dysfunction: Systematic Review and Meta-Analysis of Randomized Controlled Trials. Pain Medicine 2008; 9:634-659.