Exploring Opioid-Induced Constipation: Insights from Practice and Research
In practical surgery, indigestion and constipation can become a side problem that manifests itself in various interventions. However, with specific treatment, there is a possibility of opioid-induced constipation. They may occur due to the use of opioid painkillers for children for postoperative recovery and relief.
At the same time, the number of cases of constipation caused by opioids after surgery in children has increased rapidly from 2009, when it was first recorded, to 2012, when there were 100 such cases (Urilio et al., 2012). Thus, due to such side problems, children’s time spent in the clinic and healthcare costs increase significantly. Despite this state of affairs, there are no uniform instructions and solutions for the problem of constipation that occurs after opioid painkillers.
Background Information
For pain relief in pediatric patients, opioids are indicated as the most appropriate drug and may help to have a long-term effect. However, they can cause several side effects, including constipation, which complicates treatment. This is due to the reaction of opioids with receptors in the gastrointestinal tract (Thomas et al., 2008). Thus, peristalsis is reduced, and obstruction of the intestines is caused, interfering with defecation’s normal function. Since the gastrointestinal tract is developing in pediatric patients, they are more susceptible to these side effects (Panchal et al., 2007). Because of this, the lack of practical policies and procedures developed for such cases makes it difficult to carry out any manipulations to alleviate the condition of children.
Recommended Solution
In my practice and in general, when getting acquainted with the problem, it was possible to find out that many patients have similar problems described above. Moreover, the number of cases increases yearly, which requires introducing unique solutions in this regard. Moreover, practice confirms that discomfort accompanies this condition and can increase the time spent in the clinic (Moore & McQuay, 2005).
Because of how common the problem is, my practice should have its policy on constipation in pediatric patients. This is necessary because opioids have a severe adverse effect on the gastrointestinal tract in children, and therefore, they need the implementation of preventive policies (Bell et al., 2009). When determining that a pediatric patient will undergo surgery, it is necessary to start taking additional funds that would help restore the intestinal microbiota and thus promote better patency. Establishing special measures may be helpful to ensure that children spend less time in the clinic.
A multi-pronged approach to providing relief from the side effects of opioids can also be directed toward a comprehensive diagnosis of the gastrointestinal tract. This will help determine if the child is suffering from any problems associated with this area that could complicate treatment. Establishing a gastrointestinal care policy can eliminate significant deficiencies that might otherwise cause collateral illnesses and problems requiring a return visit. Much attention to the policy being introduced should be given to educating patients or caregivers on how they should handle their bodies after taking opioids (Kalso et al., 2004).
Early intervention strategies can, therefore, play an essential role in managing the emerging constipation problem and engaging in proactive prophylaxis after surgery and opioid use in pediatric patients. In addition, such an orientation can improve the general condition of patients through special exercises with them. This method can be combined with the search for alternative methods of anesthesia. Depending on the surgical intervention, local anesthesia or non-opioid analgesics may be used (Pergolizzi et al., 2020). Patient stool softeners are also an appropriate way for children who may be at risk of side effects from opioids.
References
Bell, T., Annunziata, K., & Leslie, J. B. (2009). Opioid-induced constipation negatively impacts pain management, productivity, and health-related quality of life: findings from the National Health and Wellness Survey. Journal of opioid management, 5(3), 137–144. Web.
Kalso, E., Edwards, J. E., Moore, A. R., & McQuay, H. J. (2004). Opioids in chronic non-cancer pain: systematic review of efficacy and safety. Pain, 112(3), 372–380. Web.
Moore, R. A., & McQuay, H. J. (2005). Prevalence of opioid adverse events in chronic non-malignant pain: systematic review of randomised trials of oral opioids. Arthritis research & therapy, 7(5), R1046–R1051. Web.
Panchal, S. J., Müller-Schwefe, P., & Wurzelmann, J. I. (2007). Opioid-induced bowel dysfunction: prevalence, pathophysiology and burden. International journal of clinical practice, 61(7), 1181–1187. Web.
Pergolizzi Jr, J. V., Christo, P. J., LeQuang, J. A., & Magnusson, P. (2020). The use of peripheral ÎĽ-opioid receptor antagonists (PAMORA) in the management of opioid-induced constipation: an update on their efficacy and safety. Drug Design, Development and Therapy, 14, 1009-1025. Web.
Thomas, J., Karver, S., Cooney, G. A., Chamberlain, B. H., Watt, C. K., Slatkin, N. E., Stambler, N., Kremer, A. & Israel, R. J. (2008). Methylnaltrexone for opioid-induced constipation in advanced illness. New England Journal of Medicine, 358(22), 2332-2343. Web.
Urilio, C., Caterina, M., Pota, V., & Sansone, P. (2012). Opioid Induced Constipation. IntechOpen.