Treating Opioid-Induced Constipation in Older Adults: New Options

Abstract

Numerous factors, such as changes in gastrointestinal physiology, reduced mobility, decreased liquid and nutritional intake, and certain comorbidities, predispose older adults to constipation. Use of opioid medications further compounds this problem. Unlike other side effects associated with opioid use, patients do not develop tolerance to constipation and other opioid-induced bowel dysfunctions. Although opioid-induced constipation has a prevalence rate of 80% in this population, it remains highly undertreated. Despite this problem, there have been limited therapeutic options available for older adults suffering from opioid-induced constipation. On September 16, 2014, a new oral agent, naloxegol, a peripherally acting muopioid receptor antagonist (PAMORA), approved by the Food and Drug Administration, provides new hope for patients. This paper explores clinical complications associated with opioid-induced constipation in older adults, analyzes the efficacy and safety of laxatives and PAMORAs, and defines the future role of naloxegol in this vulnerable population.

Mashiningan Improves Opioid-Induced Constipation in Rats by Activating Cystic Fibrosis Transmembrane Conductance Regulator Chloride Channel

“…However, the use of opioids in the treatment of chronic pain in patients with and without cancer causes bowel disorders as an adverse effect. The most frequent of these disorders is constipation, which often results in the discontinuation of opioid therapy (McNicol et al, 2003;Gyawali et al, 2015;Sani and Mahan, 2015;Nelson and Camilleri, 2016). Therefore, opioid-induced constipation compromises pain management.…”