eCase Challenge: Strategies to Address Opioid-Induced Constipation

The use of opioids for the treatment of chronic pain has increased substantially during the past decade. Despite their therapeutic benefits, however, opioids are also associated with important adverse effects, such as physical dependence, sedation, and respiratory depression. Also of pivotal concern are adverse gastrointestinal effects, the most common being opioid-induced constipation (OIC). OIC is pervasive among patients taking opioids. According to the American Gastroenterological Association (AGA), 40-80% of patients taking chronic opioids experience constipation, this data includes patients with noncancer and cancer pain. OIC can occur even at low dosages and at any time after the initiation of opioid treatment. The presence of OIC markedly diminishes patients’ functional abilities and overall quality of life. Even though the effects of opioids on bowel function have been recognized for many years, the impact of OIC on patients continues to be underestimated by healthcare professionals. Greater attention must be paid to the prevention, diagnosis, and treatment of OIC so that patients with chronic pain can derive optimal benefits from opioid therapy. As integral members of the healthcare team, we believe that PAs can be instrumental in addressing OIC in their patients on opioid therapy.

Learning Objectives
At the conclusion of this activity, the PA should be better able to:
  • Apply knowledge of the risk of opioid-induced constipation (OIC) to employ preventative measures when managing patients on opioid therapy.
  • Implement quantitative approaches to the identification of OIC.
  • Integrate treatments for OIC when managing patients on opioid therapy.