Opioid-induced bowel dysfunction: a literature review

ŻUREK, Urszula, MICHALSKA, Milena, TOŁWIŃSKI, Ignacy, LUBASZKA, Zuzanna, FIEGA, Jakub, SZEWCZYK, Dorota, KĘDZIERSKA, Zofia, ANTKOWIAK, Klaudia, DADAS, Klaudia, ŚWIERCZ, Aleksandra, MAŁACHOWSKA, Dominika, CIECIERSKI-KOŹLAREK, Hubert, SIKORSKA, Ewa and SHVED, Kateryna. Opioid-induced bowel dysfunction: a literature review. Journal of Education, Health and Sport. 2023;22(1):147-164. eISSN 2391-8306. DOI http://dx.doi.org/10.12775/JEHS.2023.22.01.012

https://apcz.umk.pl/JEHS/article/view/44804

https://zenodo.org/record/8170690

 

 

 

 

 

The journal has had 40 points in Ministry of Education and Science of Poland parametric evaluation. Annex to the announcement of the Minister of Education and Science of December 21, 2021. No. 32343.

Has a Journal's Unique Identifier: 201159. Scientific disciplines assigned: Physical Culture Sciences (Field of Medical sciences and health sciences); Health Sciences (Field of Medical Sciences and Health Sciences).

Punkty Ministerialne z 2019 - aktualny rok 40 punktów. Załącznik do komunikatu Ministra Edukacji i Nauki z dnia 21 grudnia 2021 r. Lp. 32343. Posiada Unikatowy Identyfikator Czasopisma: 201159.

Przypisane dyscypliny naukowe: Nauki o kulturze fizycznej (Dziedzina nauk medycznych i nauk o zdrowiu); Nauki o zdrowiu (Dziedzina nauk medycznych i nauk o zdrowiu).

© The Authors 2023;

This article is published with open access at Licensee Open Journal Systems of Nicolaus Copernicus University in Torun, Poland

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The authors declare that there is no conflict of interests regarding the publication of this paper.

Received: 28.06.2023. Revised: 30.06.2023. Accepted: 20.07.2023. Published: 25.07.2023.

 

 

 

 

 

Opioid-induced bowel dysfunction: a literature review

Urszula Żurek

Warszawski Szpital Południowy, ul. rtm. Witolda Pileckiego 99, 02-781 Warszawa, Poland

ORCiD: 0009-0008-3482-5381

  e-mail: ula.zurek@gmail.com

 

Milena Michalska

Państwowy Instytut Medyczny MSWiA, ul. Wołoska 137, 02-507 Warszawa, Poland

ORCiD: 0000-0002-8052-5661

e-mail: milena.michalska@interia.eu

 

Ignacy Tołwiński

Warszawski Szpital Południowy, ul. rtm. Witolda Pileckiego 99, 02-781 Warszawa, Poland

ORCiD: 0000-0003-1362-6734

e-mail: ignacyt233@gmail.com

 

Zuzanna Lubaszka

Wojewódzki Szpital Zespolony w Kielcach, ul. Grunwaldzka 45, 25-736 Kielce, Poland

ORCiD: 0009-0008-3034-1697

e-mail: zuzannalubaszka97@gmail.com

 

Jakub Fiega

Wojewódzki Szpital Zespolony w Kielcach, ul. Grunwaldzka 45, 25-736 Kielce, Poland

ORCiD: 0009-0007-9188-1382

e-mail: fiegajakub@gmail.com

 

Dorota Szewczyk

Międzyleski Szpital Specjalistyczny w Warszawie, ul. Bursztynowa 2, 04-749 Warszawa, Poland

ORCiD: 0009-0008-9269-2687

e-mail: dorota.szewczyk10@gmail.com

 

Zofia Kędzierska

Warszawski Szpital Południowy, ul. rtm. Witolda Pileckiego 99, 02-781 Warszawa, Poland

ORCiD: 0000-0002-4181-4719

e-mail: zo.kedzierska@gmail.com

 

Klaudia Antkowiak

Szpital Średzki Serca Jezusowego z.o.o ul. Żwirki i Wigury 10, 63-000 Środa Wielkopolska, Poland

ORCiD: 0009-0008-3421-2200

e-mail: klaudia.antkowiak2021@gmail.com

 

Klaudia Dadas

Warszawski Szpital Południowy, ul. rtm. Witolda Pileckiego 99, 02-781 Warszawa, Poland

ORCiD: 0009-0007-3352-9807

e-mail: klaudia.w.2703@gmail.com

 

Aleksandra Świercz

Warszawski Szpital Południowy, ul. rtm. Witolda Pileckiego 99, 02-781 Warszawa, Poland

ORCiD: 0009-0007-1535-1590

e-mail: aleksandra.swiercz1996@gmail.com

 

Dominika Małachowska

Warszawski Szpital Południowy, ul. rtm. Witolda Pileckiego 99, 02-781 Warszawa, Poland

ORCiD: 0009-0008-6305-7959

e-mail: dominika1.malachowska@gmail.com

 

 

Hubert Ciecierski-Koźlarek

Wojewódzki Szpital Specjalistyczny w Olsztynie, ul. Żołnierska 18, 10-561 Olsztyn, Poland

ORCiD: 0009-0009-4062-6888

e-mail: hubertciecierski@icloud.com

 

Ewa Sikorska

Katedra i Zakład Fizjologii Doświadczalnej i Klinicznej, Warszawski Uniwersytet Medyczny, ul. Banacha 1B, 02-097 Warszawa, Poland

ORCiD: 0000-0003-2352-650X

e-mail: ewa.sikorska@wum.edu.pl

 

Kateryna Shved

Wielospecjalistyczny Szpital Miejski im. Józefa Strusia, ul. Szwajcarska 3, 61-285 Poznań, Poland

ORCiD: 0009-0002-3773-7025

e-mail: katey.shved@gmail.com

 

Abstract

Opioid therapy plays a crucial role in the management of acute and chronic pain, with opioids being widely prescribed worldwide. However, alongside the analgesic benefits, the use of opioids is associated with a range of adverse effects, including opioid-induced bowel dysfunction. Opioid-induced bowel dysfunction refers to a constellation of gastrointestinal symptoms caused by the effects of opioids on the gastrointestinal tract. These symptoms primarily manifest as constipation, but can also include abdominal pain, bloating, nausea, and vomiting. Opioid-induced bowel dysfunction poses a significant clinical challenge, as it can severely affect patients' quality of life. Non-pharmacological approaches alone are rarely sufficient to counteract the adverse effects of opioid therapy. The primary pharmacological agents used in opioid-induced bowel dysfunction management are laxatives, which should be chosen according to individual patient needs. Patients with poorly controlled symptoms can benefit from new pharmacological approaches, particularly peripheral mu-opioid receptor antagonists. By better understanding the underlying mechanisms, clinical manifestations, diagnostic criteria, and management strategies, healthcare professionals can optimize patient care, minimize complications, and improve patients' overall well-being.

 

Aim of the study

This article aims to provide a comprehensive overview of opioid-induced bowel dysfunction, focusing on its underlying mechanisms, clinical manifestations, and management strategies. By examining the current understanding of opioid-induced bowel dysfunction, this article seeks to enhance knowledge and promote effective management of this prevalent condition. The primary goal is to equip healthcare professionals with up-to-date information to facilitate early recognition, accurate diagnosis, and management of opioid-induced bowel dysfunction. We also want to draw attention to the importance of a multidisciplinary approach in the course of opioid-induced bowel dysfunction management.

 

Materials and methods

This article presents the current state of knowledge on opioid-induced bowel dysfunction found in various scientific articles. To select them, the literature available in Google Scholar and PubMed databases was reviewed using the keywords opioid-induced bowel dysfunction, OIBD, opioid-induced constipation, OIC, opioids, adverse effects, gastrointestinal motility, laxatives, PAMORAs, peripherally acting mu-opioid receptor antagonists. From many available articles, those that best covered the topic were selected. The reviewed literature describes the pharmacology of opioids, the underlying mechanisms of opioid-induced bowel dysfunction, clinical manifestations, as well as various management strategies.

 

Keywords

opioid-induced bowel dysfunction, OIBD, opioid-induced constipation, OIC, opioids, adverse effects, gastrointestinal motility, laxatives, PAMORAs, peripherally acting mu-opioid receptor antagonists