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Prophylaxis and treatment of opioid-induced bowel dysfunction
Scandinavian Journal of Pain, 08/28/09

Kaasa T – Traditional treatment: Fibre and a stool–softener are necessary in all patients when initiating opioid treatment. Most patients on long term opioid treatment will need a more potent laxative that increases secretions and intestinal motility, and enemas for incomplete rectal emptying. However, potent laxatives have their own, often bothersome adverse effects. New specific treatment: Specific treatment with opioid antagonists is now available in Europe: Naloxone in slow release opioid tablets is effective because 98 99% of naloxone taken orally is removed during first passage through the liver. Methylnaltrexone administered subcutaneously do not cross the blood–brain barrier and reverses all adverse opioid effects on the gastrointestinal tract, without reducing the analgesic effect. Patients with severe acute or chronic pain can now obtain opioid analgesia with less bothersome gastrointestinal effects.

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