This month's quiz asks readers to determine the most appropriate treatment for persistent constipation in a 60-year-old woman taking chronic opioid analgesic therapy for reflex sympathetic dystrophy syndrome.
The oral medication is taken once per day and works in the upper GI tract to stimulate secretion of intestinal fluid, supporting regular bowel function.
This month's quiz asks readers to determine the most appropriate management for a 36-year-old woman with a 12-year history of refractory constipation that began after a difficult childbirth.
Opioid-induced constipation differs mechanistically from other forms of the disorder, and its medical management deserves dedicated attention, the American Gastroenterological Association (AGA) said.
Mu-opioid receptor antagonists appear safe, effective for opioid-induced constipation, review finds | ACP Gastroenterology Monthly
Researchers looked at randomized controlled trials of peripheral mu-opioid receptor antagonists (methylnaltrexone, naloxone, naloxegol, alvimopan, axelopran, or naldemedine) and the prescription-strength laxatives lubiprostone or prucalopride.
Four FDA-approved drugs for opioid-induced constipation form the backbone of treatment, with more options in the research pipeline.
Naloxone, naldemedine appear best for opioid-induced constipation after laxatives | ACP Gastroenterology Monthly
A meta-analysis found naloxone to have the highest efficacy and safety of pharmacological therapies for opioid-induced constipation, and previous research has shown it to be cost-effective, study authors said.
In IBS with constipation, plecanatide reduced abdominal pain and increased bowel movements at 12 wk | ACP Gastroenterology Monthly
Clinical judgment will be needed to determine whether the relatively modest improvement in outcomes will be important to patients for whom the drug is considered, according to an accompanying ACP Journal Club commentary.
In chronic severe functional constipation, electroacupuncture increased complete spontaneous bowel movements | ACP Gastroenterology Monthly
Patients undergoing electroacupuncture experienced a change from baseline in mean complete spontaneous bowel movements per week during the treatment period, and treatment effects were even greater after patients stopped attending the sessions.
Recent conference coverage featured gastroenterology and hepatology topics | ACP Gastroenterology Monthly
Conference coverage in the December ACP Hospitalist addressed acute-on-chronic liver failure and inpatient constipation.