Management of opioid-induced constipation
Thorpe DM. Pain Medicine and Palliative Care,
The Huntsman Cancer Institute,
University of Utah,
2000 Circle of Hope,
Suite 2100,
Salt Lake City, UT 84112,
Curr Pain Headache Rep 2001 Jun;5(3):237-40


Constipation is an expected side effect of opioid use and as such should be treated prophylactically. However, because it is often overlooked and under-appreciated it is one of the most common reasons patients avoid or abandon opioid use and, as a result, suffer pain needlessly. Thorough assessment, ongoing evaluation, and patient teaching are key factors in establishing an effective bowel regimen. A bowel clean-out is indicated for patients who have not had a bowel movement in more than 5 days. Once any impactions have been eliminated, a regular regimen of senna and docusate is recommended. Dietary modifications, fluids, and exercise are important but usually not sufficient to overcome opioid-induced constipation. Although many of the medicines that are used to treat pain and related symptoms come with a significant potential for distressing side effects, it is important to understand that most side effects, especially constipation, can be managed and quality of life can be preserved without sacrificing needed analgesia.
Alvimopan for OBD
Endomorphins 1 and 2
The Pleasures of Opium
Hydrocodone versus codeine
Opioid bowel dysfunction : review

and further reading

Future Opioids
BLTC Research
Utopian Surgery?
The Abolitionist Project
The Hedonistic Imperative
The Reproductive Revolution
Critique of Huxley's Brave New World

The Good Drug Guide
The Good Drug Guide

The Responsible Parent's Guide
To Healthy Mood Boosters For All The Family