ReviewUnited European gastroenterology journal2019
Pathophysiology and management of opioid-induced constipation: European expert consensus statement.
Review in United European gastroenterology journal, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. It is linked to 2 registered trials, which are not on this map. Cited by 81 papers, 5 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
The Effect of Auriculotherapy for Post-Operative Pain Management Following Rotator Cuff Surgery: A Randomized, Placebo-Controlled Study
OMAMA-study - Prevention of Opioid-induced Constipation in Patients With Advanced Cancer
Who cites it
81 citing papers in PubMed, 5 syntheses or guidelines pooled it, 167 citations in OpenAlex.
- Acupuncture-related therapies for opioid-induced constipation in patients with cancer: a systematic review and network meta-analysis.Frontiers in medicine · 2026Pooled it
- Efficacy and safety of opioid-receptor antagonists for opioid-induced constipation: a systematic review and meta-analysis.Frontiers in pharmacology · 2025Pooled it
- Analgesia in the Initial Management of Acute Pancreatitis: A Systematic Review and Meta-Analysis of Randomised Controlled Trials.World journal of surgery · 2022Pooled it
- The effects of intravenous lidocaine on wound pain and gastrointestinal function recovery after laparoscopic colorectal surgery.International wound journal · 2020Pooled it
- MASCC recommendations on the management of constipation in patients with advanced cancer.Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer · 2020Guideline
- The influence of brain metastases on the central nervous system effects of methylnaltrexone: a post hoc analysis of 3 randomized, double-blind studies.Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer · 2021Trial
- Opioids to Treat Chronic Pain in the Older Adult: A Clinical Consensus to Guarantee Safety and Avoid Adverse Events.Drugs & aging · 2026Review
- Opioid-Induced Constipation: Mechanistic Insights, Experimental Models, and Future Perspectives.Biomedicines · 2026Review
- Early detection of opioid-induced constipation in patients initiating weak opioids for chronic non-cancer pain.Scientific reports · 2026Article
- German Expert Consensus on Opioid-Induced Constipation (OIC): Recommendations and a Treatment Algorithm for Clinical Practice.Journal of clinical medicine · 2026Article
- Outcomes in patients with cancer following opioid initiation in Japan: an exploratory study.BMC research notes · 2026Article
- Drug-induced intestinal obstruction: insights from the FDA Adverse Event Reporting System.Therapeutic advances in drug safety · 2026Article
- Pharmacological and rehabilitation strategies in opioid-induced constipation: an observational study.Frontiers in rehabilitation sciences · 2026Article
- Constipation in critically ill adults.World journal of gastrointestinal pathophysiology · 2025Review
- VER-01 Shows Enhanced Gastrointestinal Tolerability, Superior Pain Relief, and Improved Sleep Quality Compared to Opioids in Treating Chronic Low Back Pain: A Randomized Phase 3 Clinical Trial.Pain and therapy · 2025Article
- Transauricular Vagus Nerve Stimulation for Postoperative Analgesia following Arthroscopic Shoulder Surgery: A Double-Blind, Randomized, Placebo-Controlled Trial.Pain and therapy · 2025Article
- Opioid-induced constipation in internal medicine: recognition and management pathways.Internal and emergency medicine · 2025Review
- PAMORAs in Opioid-Induced Constipation: Are We Following the Guidelines?Clinical and translational gastroenterology · 2025Article
- Treatment of Opioid-Induced Constipation: Inducing Laxation and Understanding the Risk of Gastrointestinal Perforation.Journal of clinical gastroenterology · 2025Review
- Article
21 more citing papers are in PubMed but not listed here.
Corrections and comments
- Erratum issuedCorrigendum.2019
Authors and funding
7 authors at 6 institutions in 6 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Background: Opioid-induced bowel dysfunction is a complication of opioid therapy, in which constipation is the most common and problematic symptom. However, it is frequently under-recognised and thus effective management is often not instituted despite a number of treatment options. Objective: The central objective of this study is to provide a summary of the pathophysiology and clinical evaluation of opioid-induced constipation and to provide a pragmatic management algorithm for day-to-day clinical practice. Methods: This summary and the treatment algorithm is based on the opinion of a European expert panel evaluating current evidence in the literature. Results: The pathophysiology of opioid-induced constipation is multi-faceted. The key aspect of managing opioid-induced constipation is early recognition. Specific management includes increasing fluid intake, exercise and standard laxatives as well as addressing exacerbating factors. The Bowel Function Index is a useful way of objectively evaluating severity of opioid-induced constipation and monitoring response. Second-line treatments can be considered in those with recalcitrant symptoms, which include gut-restricted or peripherally acting mu-opioid receptor antagonists. However, a combination of interventions may be needed. Conclusion: Opioid-induced constipation is a common, yet under-recognised and undertreated, complication of opioid therapy. We provide a pragmatic step-wise approach to opioid-induced constipation, which should simplify management for clinicians.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.