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Opioid-induced constipation (OIC) remains one of the most frequent and distressing gastrointestinal side effects encountered by patients on chronic opioid therapy. Despite the high prevalence, OIC is frequently underdiagnosed and inadequately managed, with critical effects on the quality of life of patients. Aim of this review is to promote the awareness about OIC in the context of internal medicine. We examined the statement EnhanCing Healthcare Outcomes in Opioid-Induced Constipation (ECHO OIC) by European experts to streamline the diagnosis and management of OIC in clinical practice. Such guidelines have been further discussed by an Italian expert consensus to provide national customization and a multidisciplinary approach. The key finding is the implementation of a multi-step clinical pathway for prevention, diagnosis, treatment, and long-term management of OIC, taking into account the improvement of quality of life of patients. In conclusion, we urge to expand awareness about OIC. The seven-step diagnostic-therapeutic pathway approach formulated by ECHO OIC is a pragmatic and scalable model to improve OIC management with emphasis on education, early intervention, monitoring, tailored pharmacologic strategies, and coordinated referral when necessary.
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http://dx.doi.org/10.1007/s11739-025-04091-2 | DOI Listing |
Neuropsychopharmacology
September 2025
School of Biological Sciences, Centre for Biodiscovery, Victoria University of Wellington, Wellington, 6012, New Zealand.
The development of safer mu opioid receptor (MOR) agonists with reduced side effects is a key focus of pain research. Some studies have suggested that MOR agonists with reduced β-arrestin 2 (βArr2) signaling (i.e.
View Article and Find Full Text PDFIntern Emerg Med
August 2025
Division of Internal Medicine 'A. Murri' and Department of Precision and Regenerative Medicine and Ionian Area (DiMePre-J), University of Bari 'Aldo Moro', Bari, Italy.
Opioid-induced constipation (OIC) remains one of the most frequent and distressing gastrointestinal side effects encountered by patients on chronic opioid therapy. Despite the high prevalence, OIC is frequently underdiagnosed and inadequately managed, with critical effects on the quality of life of patients. Aim of this review is to promote the awareness about OIC in the context of internal medicine.
View Article and Find Full Text PDFJ Appl Toxicol
August 2025
Department of Toxicology, Hoshi University School of Pharmacy and Pharmaceutical Sciences, Tokyo, Japan.
Typical prescribed opioids are known to inhibit intestinal transit and induce emesis-like behaviors in animals via distinct mechanisms and varying magnitudes. However, there is limited evidence regarding whether atypical opioids also produce these adverse effects in animals. This study was designed to investigate whether tramadol, its active metabolite O-desmethyltramadol (M1), and methadone cause such side effects and to elucidate their underlying mechanisms.
View Article and Find Full Text PDFPalliat Med
August 2025
Melbourne Health, Parkville, VIC, Australia.
Background: Opioid-induced constipation is a common side effect of Oxycodone. Oxycodone/Naloxone Prolonged Release (OXN PR) mitigates opioid-induced constipation in non-cancer pain, however its evidence is limited in people with pain from advanced cancer.
Aims: To demonstrate analgesic non-inferiority, and superiority in reducing constipation for Oxycodone/Naloxone Prolonged Release (OXN PR) compared to Oxycodone Prolonged Release (Oxy PR).
Neurochem Int
August 2025
Department of Human Anatomy and Histoembryology, School of Basic, Medical Sciences, Ningxia Medical University, 1160 Shengli Street, 750004, Yinchuan, Ningxia Hui Autonomous Region, PR China. Electronic address:
Opioid-induced constipation (OIC) is the most common gastrointestinal disorder associated with opioid use. It is linked to impaired neurotransmitter release. Alpha-Synuclein (α-Syn) plays a crucial role in maintaining neurotransmitter homeostasis and regulating synaptic plasticity in the nervous system.
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