ReviewAdvances in therapy2021
Management of Opioid-Induced Constipation and Bowel Dysfunction: Expert Opinion of an Italian Multidisciplinary Panel.
Review in Advances in therapy, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 30 papers, 3 of them syntheses that pooled it.
What it found
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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.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
30 citing papers in PubMed, 3 syntheses or guidelines pooled it, 50 citations in OpenAlex.
- Efficacy and Safety of Serratus Anterior Plane Block for Pain Management in Patients with Rib Fractures: A Systematic Review and Meta-Analysis of Randomized Controlled Trials.Medicina (Kaunas, Lithuania) · 2026Pooled it
- Efficacy and safety of opioid-receptor antagonists for opioid-induced constipation: a systematic review and meta-analysis.Frontiers in pharmacology · 2025Pooled it
- Traditional herbal medicine for opioid-induced constipation in patients with cancer: a systematic review and meta-analysis of randomized controlled trials.Frontiers in pharmacology · 2025Pooled it
- Acupoint Stimulation for Enhanced Recovery After Colon Surgery: A Prospective Multicenter Randomized Controlled Trial.Journal of multidisciplinary healthcare · 2022Trial
- Comments on the "Prevalence of opioid‑induced constipation in the emergency department".Internal and emergency medicine · 2026Article
- Opioid-Induced Constipation: Mechanistic Insights, Experimental Models, and Future Perspectives.Biomedicines · 2026Review
- Pharmacological and rehabilitation strategies in opioid-induced constipation: an observational study.Frontiers in rehabilitation sciences · 2026Article
- 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
- Progresses in Questing for the Truth of Opioid-Related Constipation in Cancer Patients.Journal of cellular and molecular medicine · 2025Review
- Benefits ofInternational journal of molecular sciences · 2025Article
- Peripheral Opioid Receptors in the Modulation of Inflammatory Pain: a Narrative Review.Maedica · 2025Review
- The macrogol revolution in the treatment of chronic constipation. A short history of laxatives.Frontiers in pharmacology · 2025Article
- Improving Diagnosis and Management of Opioid-Induced Constipation (OIC) in Clinical Practice: An Italian Expert Opinion.Journal of clinical medicine · 2024Article
- Efficacy and safety of elobixibat in combination with or switched from conventional treatments of chronic constipation: A retrospective observational study.JGH open : an open access journal of gastroenterology and hepatology · 2024Article
- Administration of flurbiprofen axetil and dezocine for the postoperative analgesia in patients with non‑small cell lung cancer: A randomized, controlled study.Oncology letters · 2024Article
- Opioid-induced Constipation: Old and New Concepts in Diagnosis and Treatment.Journal of neurogastroenterology and motility · 2024Review
- Gastro-Intestinal Symptoms in Palliative Care Patients.Current oncology (Toronto, Ont.) · 2024Review
- TheFrontiers in pharmacology · 2024Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
10 authors at 9 institutions in 3 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
The prescribing and use of opioid analgesics is increasing in Italy owing to a profusion in the number and types of opioid analgesic products available, and the increasing prevalence of conditions associated with severe pain, the latter being related to population aging. Herein we provide the expert opinion of an Italian multidisciplinary panel on the management of opioid-induced constipation (OIC) and bowel dysfunction. OIC and opioid-induced bowel dysfunction are well-recognised unwanted effects of treatment with opioid analgesics that can profoundly affect quality of life. OIC can be due to additional factors such as reduced mobility, a low-fibre diet, comorbidities, and concomitant medications. Fixed-dose combinations of opioids with mu (μ) opioid receptor antagonists, such as oxycodone/naloxone, have become available, but have limited utility in clinical practice because the individual components cannot be independently titrated, creating a risk of breakthrough pain as the dose is increased. A comprehensive prevention and management strategy for OIC should include interventions that aim to improve fibre and fluid intake, increase mobility or exercise, and restore bowel function without compromising pain control. Recommended first-line pharmacological treatment of OIC is with an osmotic laxative (preferably polyethylene glycol [macrogol]), or a stimulant laxative such as an anthraquinone. A second laxative with a complementary mechanism of action should be added in the event of an inadequate response. Second-line treatment with a peripherally acting μ opioid receptor antagonist (PAMORA), such as methylnaltrexone, naloxegol or naldemedine, should be considered in patients with OIC that has not responded to combination laxative treatment. Prokinetics or intestinal secretagogues, such as lubiprostone, may be appropriate in the third-line setting, but their use in OIC is off-label in Italy, and should therefore be restricted to settings such as specialist centres and clinical trials.
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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.