Constipation in patients treated with opioids: an integrative review

Authors

  • Martiniano Bezerra de Lima Escola de Saúde Pública
  • Mayane Carneiro Alves Pereira UFPI

DOI:

https://doi.org/10.5020/18061230.2017.p275

Keywords:

Analgesics, Opioid, Constipation, Pain, Neoplasms.

Abstract

Objective: To investigate the impact of Opioid-Induced Constipation (OIC) in the literature through the identification of the risk factors, symptoms and treatments. Methods: We carried out a review of scientific publications available in the Virtual Health Library (VHL), the Scientific Electronic Library Online (SciELO), the Latin-American and Caribbean Center on Health Sciences Information (LILACS) and the Medical Literature Analysis and Retrieval System Online (MEDLINE) databases. The search was carried out using the descriptors “analgesic opioids”, “constipation” and “pain” in English, Portuguese and Spanish, correlated or isolated. We searched for publications dating from 2011 to 2016 that investigated patients receiving treatment for pain with continuous use of opioids and with constipation as a clinical outcome. Results: The results highlighted constipation as the main secondary effect of opioids, which are very important for the control of cancer pain, and identified the risk factors for the disease. In addition, patients who were well served by health professionals presented better adherence to OIC treatment. Conclusion: The OIC control provides abdominal comfort, self-care and reduction in treatment costs. The importance of training health professionals and promoting prevention and periodic monitoring of patients should be highlighted. In addition, diet therapy and drug therapy should be provided early.

Downloads

Download data is not yet available.

Author Biographies

Martiniano Bezerra de Lima, Escola de Saúde Pública

Nutricionista residente

Mayane Carneiro Alves Pereira, UFPI

Mestre em Ciências e Saúde

References

Baltieri DA, Strain EC, Dias JC, Scivoletto S, Malbergier A, Nicastri S, et al. Diretrizes para o tratamento de pacientes com síndrome de dependência de opióides no Brasil. Rev Bras Psiquiatr [Internet]. 2004 [acesso em 2016 Fev 18];26 (4):259-69. Disponível em: http://dx.doi.org/10.1590/S1516-44462004000400011

Tanaka PP, Moss J. O papel dos antagonistas periféricos dos opióides no tratamento da dor e nos cuidados perioperatórios. Rev Bras Anestesiol [Internet]. 2008 [acesso em 2016 Fev 27]; 58(5): 533-547. Disponível em: http://dx.doi.org/10.1590/S0034-70942008000500011

Duarte DF. Uma breve história do ópio e dos opióides. Rev Bras Anestesiol [Internet]. 2005 [acesso em 2016 Fev 29]; 55(1):135-46. Disponível em: http://dx.doi.org/10.1590/S0034-70942005000100015

Ministério da Saúde (BR), Instituto Nacional de Câncer. Cuidados paliativos oncológicos: controle da dor. Rio de Janeiro: INCA, 2001.

Caponero R, Jorge JMN, Melo AGC. Consenso brasileiro de constipação intestinal induzida por opióides. Rev Bras Cuidados Paliativos [Internet]. 2009 [acesso em 2016 Mar 03]; Supl 1:1-34. Disponível em:http://www.cuidadospaliativos.com.br/img/din/file/consenso_constip.pdf

Santos HS. Terapêutica nutricional para constipação intestinal em pacientes oncológicos com doença avançada em uso de opiáceos: revisão. Rev Bras Cancerol. 2002;48(2):263-9.

Agra G, Fernandes MA, Platel ICS, Barros NCB, Freire MEM. Constipação em pacientes com doença oncológica avançada em uso de opioides. Mundo Saúde. 2013;37(4):472-8.

Kurz A, Sessler DI. Opioid-induced bowel dysfunction: pathophysiology and potential new therapies. Drugs. 2003;63:649-71.

Mendes KDS, Silveira RCCP, Galvão CM. Revisão integrativa: método de pesquisa para a incorporação de evidências na saúde e na enfermagem. Texto & Contexto Enferm [Internet]. 2008 [acesso em 2016 Fev 11];17(4):758-64. Disponível em:http://dx.doi.org/10.1590/S0104-07072008000400018

Dzierzanowski T, Ciałkowska-Rysz A. Behavioral risk factors of constipation in palliative care patients. Support Care Cancer [Internet]. 2015 [acesso em 2016 Fev 11];23:1787–93. Disponível em:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4555193/pdf/520_2014_Article_2495.pdf

Chumpitaz-Corredor D, Lara-Solares A. Existe correlación entre la dosis de opioide y el tiempo de respuesta a metilnaltrexona. Rev Soc Esp Dolor [Internet]. 2012 [acesso em 2016 Mar 25];19(1):11-7. Disponível em: http://scielo.isciii.es/pdf/dolor/v19n1/original2.pdf

Gálvez R, Provencio M, Cobo M, Pérez C, Pérez C, Canal J. Prevalencia y severidad de la disfunción intestinal inducida por opioides. Atención Primaria [Internet]. 2014 [acesso em 2016 Mar 16];46(1):32–39. Disponível em: http://ac.elscdn.com/S0212656713002722/1-s2.0-S0212656713002722-main.pdf?_tid=08f40dc8-9d7a-11e6-90a9-00000aab0f6c&acdnat=1477705994_f81358dbe16d3aef24e279c3b53af3c0

Takemoto ML, Fernandes RA, Almeida GR, Monteiro RD, Colombini-Neto M, Bertola-Neto A. Health care resource use and costs in opioid-treated patients with and without constipation in Brazil. Value Health [Internet]. 2011 [acesso em 2016 Fev 15];14:78–81 Disponível em:

http://www.ispor.org/consortiums/latinamerica/documents/ViH/Health-Care-Resource-Use-and-Costs.pdf

Laugsand EA, Jakobsen G, Kaasa S, Klepstad P. Inadequate symptom control in advanced cancer patients across Europe. Support. Care Cancer [Internet]. 2011 [acesso em 2016 Mar 30];19:2005-14. Disponível em:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3204099/pdf/520_2010_Article_1051.pdf

Shu-Yu T, Chung-Yin L, Chien-Yi W, Hui-Ya H, Joh-Jong H, Chia-Tsuan H, et al. Symptom patterns of advanced cancer patients in a palliative care unit: longitudinal assessments of symptoms improvement. BMC Palliat Care [Internet]. 2016 [acesso em 2016 Mar 30];15(1):32. Disponível em:https://www.researchgate.net/publication/297895780_Symptom_severity_of_patients_with_advanced_cancer_in_palliative_care_unit_Longitudinal_assessments_of_symptoms_improvement

Nunes BC, Garcia JBS, Sakata RK. Morfina como primeiro medicamento para tratamento da dor de câncer. Rev Bras Anestesiol [Internet]. 2014 [acesso em 2016 Mar 30];64(4):236-40. Disponível em: http://www.scielo.br/pdf/rba/v64n4/pt_0034-7094-rba-64-04-00236.pdf

Marmo MCR, Caran EMM, Puty FCB, Morais MB. Avaliação do hábito intestinal em pacientes com câncer que utilizam morfina para o controle da dor. Rev Dor [Internet]. 2012 [acesso em 2016 Mar 16];13(3):243-8. Disponível em: http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1806-00132012000300009&lng=en&nrm=iso

Feudtner C, Freedman J, Kang T, Womer JW, Dai D, Faerber J. Comparative effectiveness of senna to prevent problematic constipation in pediatric oncology patients receiving opioids: a multicenter study of clinically detailed administrative data. J Pain Symptom Manage [Internet]. 2014 [acesso em 2016 Mar 25];48(2):272-80. Disponível em: http://www.jpsmjournal.com/article/S0885-3924(13)00608-8/pdf

LoCasale RJ, Datto C, Wilson H, Yeomans K, Coyne KS. The burden of opioid-induced constipation: discordance between patient and health care provider reports. J Manag Care Spec Pharm [Internet]. 2016 [acesso em 2016 Mar 30];22(3):236-45. Disponível em: http://www.jmcp.org/doi/pdf/10.18553/jmcp.2016.22.3.236

Downloads

Published

2017-06-06

How to Cite

de Lima, M. B., & Alves Pereira, M. C. (2017). Constipation in patients treated with opioids: an integrative review. Brazilian Journal in Health Promotion, 30(2). https://doi.org/10.5020/18061230.2017.p275

Issue

Vol. 30 No. 2 (2017)

Section

Articles for review

License

Submitted manuscripts must be exclusively destined to RBPS and are not allowed to be submitted to another journal. When submitting the manuscript, authors must include the Declaration of Responsibility and Assignment of Copyright signed by all authors. The document must describe individual contribution to the preparation of the manuscript and be submitted in a pdf format. The author may deposit the final version of the article with post-print peer review in any repository or website under the Creative Commons Attribution 4.0 International License.