VIDEO: How to approach opioid-induced and -exacerbated constipation

Editor’s note: This is a previously posted video, and the below is an automatically generated transcript to be used for informational purposes. Please notify editor@healio.com if there are concerns regarding accuracy of the transcription.

In terms of the treatment approach, it's similar to the treatment of chronic idiopathic constipation, to start out with. But in general, patients with opioid induced constipation are patients who did not have issues with constipation before starting on opiates. So the constipation was triggered by opiates. Now, very commonly you'll see patients who have had chronic constipation but they take opiates for one reason or another and have opiate exacerbated constipation. So their chronic constipation is worsened by the opiates. And in terms of treatment approach, if possible, avoid or taper off the opiates. But there are some patients with chronic pain that they cannot come off the opiates for one reason or another. They're on stable doses and it allows them to be functional. In those patients, I use a step up approach in terms of choosing the cheaper therapies to start with like Polyethylene glycol and then escalate, if necessary, to the secretagogues and Pamorex.