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Registration date : 2008-11-09
 | | Subject: OIC: Opiate Induced Constipation Part 1 Wed 03 Mar 2010, 12:13 am | |
|  The following is a rather long but important article so I will be posting it in parts. This will be part one with part two to follow. All About Opioids and Opioid-Induced Constipation (OIC)
Causes of Opioid-Induced Constipation (OIC)What is constipation?Constipation can be defined as a decrease in the frequency of passing formed stools. The condition also may be characterized by stools that are hard and difficult to pass.
What causes constipation?
Constipation may be the result of inadequate fiber intake, inadequate fluid intake, or a lack of physical activity. It may also be caused by disease or ailments such as diabetes, intestinal obstruction, spinal cord compression, excessive calcium levels, a lack of potassium, or kidney problems. A third cause of constipation is pharmacologically based. That is, constipation is a side-effect of drugs that are used to treat various diseases and pain, such as the opioids given to cancer patients.How do opioids cause constipation?Opioids are effective pain relievers, but often have the side effect of constipation. These medicines affect the gastrointestinal tract in a variety of ways. Opioids increase the amount of time it takes stool to move through the gastric system. They increase nonpropulsive contractions in the middle of the small intestine (jejunum) and decrease longitudinal propulsive peristalsis - motions critical to moving food through the intestines. This results in food that fails to travel through the digestive tract. Opioids are also able to partially paralyze the stomach (gastroparesis) so that food remains in the digestive organ for a longer period of time. Additionally opioids reduce digestive secretions and decrease the urge to defecate. Symptoms of OICSeveral physical and other symptoms are prevalent in sufferers of opioid-induced constipation (OIC). Physicians usually will gather patient history information to check for standard problems associated with constipation such as too little fiber and fluid intake, too little exercise, underlying medical problems, and current medications. Be prepared for a physical assessment that requires oral, abdominal, and digital anorectal examinations. Common physical symptoms of OIC include:- Stools that are hard and dry
- Difficulty such as straining, forcing, and pain when defecating
- A constant feeling that you need to use the toilet
- Bloating, distention, or bulges in the abdomen
Other symptoms of OIC include: Treatment options for OICAlthough opioids are very effective for treating and managing pain, their use frequently results in opioid-induced constipation (OIC). Treatment options for OIC may be as simple as changing diet or as complicated as requiring several medicines and laxatives. Changing lifestyle factors is usually the first recommendation that physicians make for the prevention or treatment of constipation. This includes:
- Increasing exercise or physical activity
- Increasing time and privacy for toileting
Changes in lifestyle, however, may not be possible for many patients. In addition, these changes may be ineffective in treating OIC. If there is a concurrent underlying disease or medicine that is causing constipation, the disease may need to be treated separately or another treatment regimen may have to be considered.
Please stayed tuned for Part 2 of opiate Induced Constipation. Reference: Medical News TodayPhotos from the Wyeth Library | |
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