Skip to main content
AAHPM Logo
Login
  • Join/Renew
  • Blog
  • Contact
Menu Search Account
  • Membership
    • Join/Renew
      • Member Benefits
    • Diversity & Inclusion
    • Getting Involved
    • Communities
      • Advanced Lung Disease Forum
      • Psychiatry, Psychology, Mental Health Forum
      • Social Work Forum
      • SIG Instructions
      • Join a SIG
      • Member Councils
    • Mentor Match
    • FAAHPM
      • Current Fellows
    • Member Directory
  • Education & Practice
    • Writing Instructional Objectives
    • Meetings
      • Annual Assembly
        • Back to Meetings
        • Assembly Home
        • Why Attend
        • Educational Sessions
        • Continuing Education
        • Call 1 - Sessions, Workshops, SIG Symposia, Educational Exchange
        • Plan Your Trip
        • Exhibits & Advertising
        • Special Events
      • Board Review Course
        • Back to Meetings
        • IBRC Home
      • Pediatrics Course
      • Calendar
      • Summer Travel
    • Publications
      • JPSM
        • Members JPSM
      • PC-FACS
        • Members - PC-FACS
      • Quarterly
        • Members Quarterly Full Access
        • Fall 16 AAHPM News
        • Fall 16 Advocacy Update
        • Fall 16 Art of Caring
        • Fall 16 Assembly Promo
        • Fall 16 Clinical Pearls
        • Fall 16 Ethics
        • Fall 16 Feature
        • Fall 16 HMDCB Update
        • Fall 16 President's Message
        • Fall 16 Quarterly Progress Report
        • Winter 16 Advocacy Update
        • Winter 16 AAHPM News
        • Winter 16 Art of Caring
        • Winter 16 Clinical Pearls
        • Winter 16 Ethics
        • Winter 16 Feature
        • Winter 16 HMDCB Update
        • Winter 16 President's Message
        • Winter 16 Quarterly Progress Report
        • Winter 16 Assembly Paper Sessions
        • Spring 17 AAHPM News
        • Spring 17 Art of Caring
        • Spring 17 Clinical Pearls
        • Spring 17 Feature
        • Spring 17 HMDCB Update
        • Spring 17 President's Message
        • Spring 17 Quarterly Progress Report
        • Spring 17 Stay Certified
        • Summer 17 AAHPM News
        • Summer 17 Advocacy Update
        • Summer 17 Art of Caring
        • Summer 17 Clinical Pearls
        • Summer 17 Ethics
        • Summer 17 Feature
        • Summer 17 HMDCB Update
        • Summer 17 Pathways to Palliative Care
        • Summer 17 President's Message
        • Summer 17 Quarterly Progress Report
        • Summer 17 Annual Assembly
        • Fall 17 President's Message
        • Fall 17 Advocacy Update
        • Fall 17 Clinical Pearls
        • Fall 17 Feature
        • Fall 17 Pathways to Palliative Care
        • Fall 17 Art of Caring
        • Fall 17 Quarterly Progress Report
        • Fall 17 Annual Assembly
        • Fall 17 AAHPM News
        • Winter 17 AAHPM News
        • Winter 17 Annual Assembly
        • Winter 17 Art of Caring
        • Winter 17 Clinical Pearls
        • Winter 17 Feature
        • Winter 17 HMDCB Update
        • Winter 17 All About Essentials
        • Winter 17 Pathways to Palliative Care
        • Winter 17 President's Message
        • Winter 17 Quarterly Progress Report
        • Spring 18 Clinical Pearls
        • Spring 18 Diversity & Inclusion
        • Spring 18 Feature
        • Spring 18 HMDCB Update
        • Spring 18 Pathways to Palliative Care
        • Spring 18 Presidents Message
        • Spring 18 Quarterly Progress Report
        • Spring 18 AAHPM News
        • Spring 18 Art of Caring
      • SmartBriefs
    • Self-Study
      • Board Prep Materials
      • Essentials
      • Primer
      • HPM PASS
      • HPM FAST
        • HPM FAST CME
      • Hospice Products
        • HMD Manual
        • HMD PREP
      • Opioid REMS
      • Recordings
      • hpmpasscme
    • Fellowships
      • Competencies
        • Pediatric Competencies
      • Accreditation
      • NRMP Match
      • Grants
        • Hearst Grant
        • Samuels Grants
        • Ho/Chiang Foundation
    • CME
    • Quality
      • Measuring What Matters
      • Quality Reporting
        • Quality - PQRS
        • Quality - VBM
        • Quality - EHR Incentive
      • Quality Guidelines
      • Quality Resources
      • HPM Quality Community
      • Quality Registries
      • Quality Education Resources
    • Research
      • Research Funding
      • Successful Research Grants
    • HPMQ
  • Advocacy
    • Stay Informed
      • State ListServ
      • Public Policy Committee
      • HPAU
        • HPAU Archive
        • Profiles - Midland
        • Profiles - Optum
        • Profiles - Palo Alto
        • Profiles - Optio Health Services
        • Profiles - At Home SUPPORT
        • Profiles - Summa Health System
        • Hospice of Dayton Focused Care
    • Take Action
    • Key Issues
      • Advance Care Planning Key Issue
      • Opioids
      • Workforce/PCHETA
    • Count Us In
  • Career Development
    • Jobs
    • Clinical Training
      • Additional Training
    • Leadership Training
      • AAHPM Ignite
      • AAHPM Ascend
        • Leadership Forum Faculty and Facilitators
        • Ascend Overview
        • Ascend Schedule
        • Ascend Facilitators
      • AAHPM Elevate
      • External Programs
    • Certification
      • Allopathic
        • Certified HPM Physicians Number
      • Hospice
        • HMDCB Research
      • Osteopathic
    • Scholarships
      • Developing Country
      • Access Fund
      • HPM Lecture Series
      • Research Scholars
      • Pediatric Scholarship
    • MOC/OCC
    • Workforce Study
    • Global Palliative Care
  • About
    • History
    • Position Statements
      • Access to Palliative Care and Hospice Position Statement
      • Artificial Nutrition Position Statement
      • Research Ethics Position Statement
      • Palliative Sedation Position Statement
      • Physician-Assisted Dying Position Statement
      • Withholding Position Statement
      • Physician Assisted Dying Position Statement Review
      • Physician-Assisted Dying
    • Talking About HPM
      • Advance Directives-Talking HPM
      • Choosing a Hospice Program-Talking HPM
      • Defining HPM-Talking HPM
      • Explaining PAD-Talking HPM
      • Costs-Talking HPM
      • Withdrawing LST-Talking HPM
      • Choosing Wisely
      • Members Talking About HPM
    • Governance
      • Board of Directors
        • Board Only
      • Committees
      • Staff
        • Staff
      • Revised Bylaws
    • Strategic Plan
    • Awards
      • Visionaries in HPM
    • Shaping the Future
      • Shaping the Future
      • Multi-Year Pledge
      • Donation Information
      • Shaping the Future Donors
    • 40 Under 40
    • Diversity & Inclusion Strategic Plan
    • Supporters
    • Social Media
  • Store
    • Browse All
    • Books
    • E-Learning
    • Recordings
    • Essentials
  • Username/Password
  • CE/Evaluations
  • Membership
  • Pay Orders
  • Downloads
  • E-Books
  • Profile
  • Addresses
  • Contact Info
  • Emergency Info
  • Purchase History
  • Handouts
  • Volunteering
  • Logout
  • Writing Instructional Objectives
  • Meetings
    • Annual Assembly
    • Board Review Course
    • Pediatrics Course
    • Calendar
    • Summer Travel
  • Publications
    • JPSM
    • PC-FACS
    • Quarterly
    • SmartBriefs
  • Self-Study
    • Board Prep Materials
    • Essentials
    • Primer
    • HPM PASS
    • HPM FAST
    • Hospice Products
    • Opioid REMS
    • Recordings
    • hpmpasscme
  • Fellowships
    • Competencies
    • Accreditation
    • NRMP Match
    • Grants
  • CME
  • Quality
    • Measuring What Matters
    • Quality Reporting
    • Quality Guidelines
    • Quality Resources
    • HPM Quality Community
    • Quality Registries
    • Quality Education Resources
  • Research
    • Research Funding
    • Successful Research Grants
  • HPMQ

Clinical Pearls

Management of Opioid-Induced Constipation

Leah Sera, PharmD BCPS

Constipation is a common, predictable, and troublesome side effect related to the use of opioids. Estimates of the prevalence of opioid-induced constipation (OIC) in terminally ill patients ranges from 40% to 90%.1,2 Although patients often become tolerant to opioid side effects such as sedation and nausea, tolerance to constipation does not develop. Inadequately managed constipation can lead to bloating, anorexia, nausea, vomiting, or intestinal obstruction. Clinicians must therefore anticipate the development of OIC, treat prophylactically with laxatives, and have a plan to manage constipation that doesn’t respond to first-line, over-the-counter therapies.

Definition and Assessment

OIC may be defined as a decreased frequency of bowel movements, bowel movements associated with straining, incomplete evacuation, and hard stools after initiation of opioid therapy.3 The binding of opioids to μ receptors in the gut results in physiological changes that include reduced gastrointestinal secretions, increased fluid absorption, decreased peristalsis, and increased anal sphincter tone.4 These effects culminate in the reduced passage of harder, dryer stools through the gastrointestinal tract.


You have reached a members only page. To read the full text, please login using the “login” button at the top of this site.

Not a member? Join AAHPM to gain access to full articles, member discounts, and the AAHPM Connect discussion community.

Join AAHPM

Essential Practices in Hospice and Palliative Medicine

Now available for order!

This newly updated and rebranded comprehensive self-study provides a critical foundation for those who want to incorporate principles of hospice and palliative medicine into their daily lives.

Learn More

Quick Links

  • Job Mart
  • JPSM
  • CME/CE Certificates
  • Purchased Downloads
  • Terms and Conditions
  • Privacy Policy

For Exhibitors and Advertisers

  • Commercial Support
  • Exhibiting and Advertising
  • Industry Relations Council
  • Mailing Labels

For Students and Residents

  • Membership
  • Career Pathways
  • Fellowships
  • Publications
Facebook Twitter Linked In Visit our patient website: PalliativeDoctors.org

AAHPM Logo

8735 West Higgins Road, Suite 300 Chicago, IL 60631

Phone 847-375-4712 Fax 847-375-6475 E-mail info@aahpm.org

Copyright © American Academy of Hospice and Palliative Medicine