By Briana Davis, Clinical Trials of Texas, Inc.
SAN ANTONIO – Chronic pain is the leading cause of disability in the United States. Given the fundamental effect chronic pain can have on quality of life, many sufferers require pharmacological (prescription drug) intervention. Opioids, in particular, are often considered the “gold standard” for pain management in patients who do experience an inadequate response to over-the-counter medications.
Opioids (e.g., oxycodone, hydrocodone, codeine and morphine) are powerful drugs that have been used for centuries to treat and manage pain. They work by blocking the transmission of pain messages to the brain, ultimately changing the patient’s emotional and physical response to pain. Although opioid use can be a very effective pain management tool, its use frequently results in debilitating bowel dysfunction – namely opioid-induced constipation (OIC).
Opioids affect the gastrointestinal tract and normal bowel function in a number of ways. Physical symptoms of OIC may include difficulty when defecating such as straining, forcing or pain, dry or hard stools, excessive bloating, abdominal tenderness and a constant feeling of needing to use the toilet. OIC can also result in psychological symptoms such as depression, lethargy and appetite loss.
OIC is often treated with a combination of lifestyle modifications and medication. Lifestyle and diet changes may include consuming more fiber and liquids, increasing physical activity and establishing a toileting routine. Medication therapy may include both laxatives and/or cathartics (stool softeners). Periodic use of suppositories, enemas, colonic irrigation or manual evacuation may also be necessary.
Unfortunately, it is often difficult for many OIC sufferers to find a treatment for constipation that works. Several days or weeks may pass before they are able to complete a bowel movement. For some people the burden of OIC can significantly diminish quality of life and may be considered even more distressing than chronic pain. Patients in this category often opt to discontinue their long-term opioid treatment and suffer with daily pain.