Methylnaltrexone for opioid-induced constipation in patients at the end of life

摘要

Opioids are frequently used for pain management, especially in patients with advanced disease who are at the end-of life. Regrettably, opioid use often comes with some unwanted gastrointestinal side-effects. Constipation is a common concern with opioid use and can be present in up to 50% of patients taking opioids for pain management (Hellwig, 2013). Constipation can lead to straining, bloating, abdominal distention, discomfort and pain. When constipation becomes a problem, too frequently the first solution becomes to reduce the amount of opioid being given, which can lead to worsening pain and ultimately poorer quality of life. Healthcare providers often underestimate the impact opioid use has on bowel function and the ultimate effect it has on quality of life.