Constipation in cancer patients on morphine

Abstract

Constipation affects a large proportion of cancer patients taking oral morphine. Constipation in these patients is generally inadequately treated.

Enteric Nervous System: Neuropathic Gastrointestinal Motility

“…Neuropathic action of narcotics in the ENS is expressed as constipation at the whole animal level of organization [20,21]. Opiates and opioids induce non-propulsive intestinal motility and suppress mucosal secretion of H 2 O and electrolytes, each of which reflects suppression of excitability in ENS motor neurons [22][23][24].…”

Avaliação do hábito intestinal em pacientes com câncer que utilizam morfina para o controle da dor

“…In spite of the small number of patients, these results may be considered similar to the international literature 17,18 and are attributed, in addition to the drugs, to the fact that the study was prospective and that specific attention was given to constipation. It is worth reminding that, according to the literature, constipation secondary to morphine affects 70% to 80% of terminal patients and is difficult to contro l7, 13,14,19 . Our study has shown that it was possible to control constipation for most patients.…”

Effectiveness and Tolerability of Amidotrizoate for the Treatment of Constipation Resistant to Laxatives in Advanced Cancer Patients

“…3 Constipation in most patients is generally inadequately treated. Although a survey in the UK showed that, for 75% of patients, no change in the perception of constipation was observed and severity of constipation was overestimated by nurses, 4 in an analysis of randomized comparative trials, all the laxatives demonstrated a limited level of efficacy and a significant number of patients required rescue treatments. 5 The literature about the use of laxatives by palliative care units shows that appropriate doses of laxatives are not commonly administered.…”

“…5 The literature about the use of laxatives by palliative care units shows that appropriate doses of laxatives are not commonly administered. 4 Moreover, a combination of drugs acting with different mechanisms is only minimally reported. 3 This topic remains controversial because there is no scientific evidence on the treatment of constipation.…”