Medical management of opioid-induced constipation differs from other forms of condition

Traditional laxatives are recommended as first-line agents to treat patients with a confirmed diagnosis of opioid-induced constipation (OIC), according to a new guideline from the American Gastroenterological Association (AGA). If an adequate trial of laxatives results in suboptimal symptom control, the guidelines recommend peripherally-acting mu-opioid receptor antagonist (PAMORA) drugs, namely naldemedine, naloxegol and methylnatrexone. This class of drugs has shown to improve bowel symptoms without compromise to pain relief, although there can be associated side effects, including diarrhea and abdominal pain. The new guideline1 and accompanying technical review2 have been published in Gastroenterology, the official journal of the AGA Institute.