The opioid bowel syndrome: A review of pathophysiology and treatment

Davis, Mellar P.

doi:10.5055/jom.2005.0035

Cited by 26 publications

(1 citation statement)

References 58 publications

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“…In addition, endogenous gastrointestinal motility promotors such as motilin and gastrin have been reported to be decreased in the serum of patients with constipation [137,138]. Likewise, treatment with opioid agonists inhibits gastrointestinal motility by direct or indirect action through modulating the release of neurotransmitters involved in gastrointestinal peristalsis [139]. This indicates that MOR antagonists, once applied prior to or simultaneously with opioid analgesics, would inhibit gastrointestinal changes including constipation.…”

Section: Opioid Antagonists and The Gut Microbiomementioning

confidence: 99%

Insights into the Current and Possible Future Use of Opioid Antagonists in Relation to Opioid-Induced Constipation and Dysbiosis

Essmat,

Karádi,

Zádor

et al. 2023

Molecules

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Opioid receptor agonists, particularly those that activate µ-opioid receptors (MORs), are essential analgesic agents for acute or chronic mild to severe pain treatment. However, their use has raised concerns including, among others, intestinal dysbiosis. In addition, growing data on constipation-evoked intestinal dysbiosis have been reported. Opioid-induced constipation (OIC) creates an obstacle to continuing treatment with opioid analgesics. When non-opioid therapies fail to overcome the OIC, opioid antagonists with peripheral, fast first-pass metabolism, and gastrointestinal localized effects remain the drug of choice for OIC, which are discussed here. At first glance, their use seems to only be restricted to constipation, however, recent data on OIC-related dysbiosis and its contribution to the appearance of several opioid side effects has garnered a great of attention from researchers. Peripheral MORs have also been considered as a future target for opioid analgesics with limited central side effects. The properties of MOR antagonists counteracting OIC, and with limited influence on central and possibly peripheral MOR-mediated antinociception, will be highlighted. A new concept is also proposed for developing gut-selective MOR antagonists to treat or restore OIC while keeping peripheral antinociception unaffected. The impact of opioid antagonists on OIC in relation to changes in the gut microbiome is included.

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Section: Opioid Antagonists and The Gut Microbiomementioning

confidence: 99%