Opioid-Induced Constipation (OIC)

What is opioid-induced constipation (OIC)?

Constipation may be defined as having one or more of the following symptoms:

  • Hard, dry stools
  • Stools become less frequent
  • Excessive straining when evacuating bowels
  • Sense of incomplete bowel evacuation
  • Excessive time spent on toilet
  • Abdominal pain/bloating
  • Rectal bleeding due to anal fissures and/or hemorrhoids

 

Depending on cause, constipation may be classified as primary or secondary.

  • Primary constipation: results from colorectal defects.
  • Secondary constipation: caused by disease or intestinal obstruction. Can also be caused by medications such as opioids.

 

Opioids are a major class of pain-relieving medications. One of the most common side effects of opioids is constipation, with incidence ranging from 40-80%.

  • Opioids relieve pain by binding to mu-opioid receptors in the central nervous system.
  • These medications also bind to mu-receptors in other parts of the body such as the gastrointestinal (GI) tract.
  • This can prevent the muscles in your intestines from pushing stools through the gut.
  • Since waste takes longer to pass through, the intestines may absorb too much water from your stools- making them hard and dry.

 

There are many effective self-care techniques to alleviate opioid-induced constipation. These may include:

  • Exercise
  • Drinking plenty of water
  • Making dietary changes
  • Using a laxative

 

Patients may also talk to their doctor about reducing opioid dosage or trying a prescription medication to treat their constipation.

 

# OIC BY THE NUMBERS #
  • Constipation is one of the most common side effects of opioid usage, with incidence ranging from 40-80%
  • In one survey, about a third of patients reported reducing opioid dosage to ease a bowel movement, with 92% of these patients reporting increased pain after the altered dose.
 
abdominal xray
 
 

Sources:
  •  Nelson, Alfred D., and Michael Camilleri. "Opioid-induced Constipation: Advances and Clinical Guidance." Therapeutic Advances in Chronic Disease. SAGE Publications, Mar. 2016. Web. 17 Apr. 2017.
  • "Opioids and Constipation." Pharmacy Times. N.p., n.d. Web. 17 Apr. 2017.
  • "Treatment for Opioid-Induced Constipation (OIC)." Medical News Today. MediLexicon International, n.d. Web. 17 Apr. 2017.

 

Over-the-counter laxatives can help soften stools and provide immediate relief. However, there are a handful of natural treatment options that can alleviate discomfort. Here are seven natural remedies for constipation:
 
OIC infographic

 

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