Pharmacological treatment of constipation in palliative care
- PMID: 23478431
- DOI: 10.1097/SPC.0b013e32835f1e17
Pharmacological treatment of constipation in palliative care
Abstract
Purpose of review: The prevalence of constipation in palliative care patients varies. There is uncertainty about the choice from varying recommendations for pharmacological management of constipation and a varying clinical practice in palliative care settings. The purpose of the review was to evaluate the current recommendations of therapy guidelines and to determine the effectiveness and safety of laxative administration for the management of constipation in palliative care patients.
Recent findings: Despite the clinical importance, there are limited data on the efficacy and safety of laxatives in palliative care patients. The social acceptability varies from country to country, but overall, oral laxatives should, where possible, be used in preference. Systemic opioid antagonists, such as naloxone and methylnaltrexone have been studied in few clinical trials. There is a paucity of well designed, prospective, randomized controlled trials with large enough numbers of patients suffering from constipation and treated with pharmacological methods.
Summary: There are limited data available on the conventional pharmacological treatment of constipation in palliative care patients due to insufficient randomized controlled trials. However, subcutaneously administered methylnaltrexone was found to be effective in aiding of laxation and well tolerated with limited or transient side effects in palliative care patients.
Similar articles
-
Methylnaltrexone: a subcutaneous treatment for opioid-induced constipation in palliative care patients.Int J Palliat Nurs. 2009 Nov;15(11):533-40. doi: 10.12968/ijpn.2009.15.11.45492. Int J Palliat Nurs. 2009. PMID: 20081727
-
Laxatives or methylnaltrexone for the management of constipation in palliative care patients.Cochrane Database Syst Rev. 2011 Jan 19;(1):CD003448. doi: 10.1002/14651858.CD003448.pub3. Cochrane Database Syst Rev. 2011. Update in: Cochrane Database Syst Rev. 2015 May 13;(5):CD003448. doi: 10.1002/14651858.CD003448.pub4. PMID: 21249653 Updated. Review.
-
Methylnaltrexone: a novel approach for the management of opioid-induced constipation in patients with advanced illness.Expert Rev Gastroenterol Hepatol. 2009 Oct;3(5):473-85. doi: 10.1586/egh.09.42. Expert Rev Gastroenterol Hepatol. 2009. PMID: 19817669 Review.
-
Management of constipation in patients receiving palliative care.Am Fam Physician. 2011 Dec 1;84(11):1227-8. Am Fam Physician. 2011. PMID: 22150655 No abstract available.
-
Methylnaltrexone treatment of opioid-induced constipation in patients with advanced illness.J Pain Symptom Manage. 2009 Nov;38(5):683-90. doi: 10.1016/j.jpainsymman.2009.02.234. Epub 2009 Aug 26. J Pain Symptom Manage. 2009. PMID: 19713070 Clinical Trial.
Cited by
-
Laxative co-medication and changes in defecation patterns during opioid use.J Oncol Pharm Pract. 2019 Oct;25(7):1613-1621. doi: 10.1177/1078155218801066. Epub 2018 Sep 27. J Oncol Pharm Pract. 2019. PMID: 30260269 Free PMC article.
-
Interventions for treating constipation in pregnancy.Cochrane Database Syst Rev. 2015 Sep 4;2015(9):CD011448. doi: 10.1002/14651858.CD011448.pub2. Cochrane Database Syst Rev. 2015. PMID: 26342714 Free PMC article. Review.
-
Advances in understanding and improving gastrointestinal symptoms during supportive and palliative care: a decade of progress.Curr Opin Support Palliat Care. 2016 Jun;10(2):149-51. doi: 10.1097/SPC.0000000000000215. Curr Opin Support Palliat Care. 2016. PMID: 27054289 Free PMC article. No abstract available.
-
Cancer Pain Management: Opioid Analgesics, Part 2.J Adv Pract Oncol. 2017 Sep-Oct;8(6):588-607. Epub 2017 Sep 1. J Adv Pract Oncol. 2017. PMID: 30310721 Free PMC article. Review.
-
Constipation in Elderly Patients with Noncancer Pain: Focus on Opioid-Induced Constipation.Drugs Aging. 2016 Aug;33(8):557-74. doi: 10.1007/s40266-016-0381-2. Drugs Aging. 2016. PMID: 27417446 Free PMC article. Review.
Publication types
MeSH terms
Substances
LinkOut - more resources
Full Text Sources
Other Literature Sources
Medical
Research Materials
