Blackney Kevin A, Kamdar Nirav V, Liu Chang Amber, Edwards David A
From the Kaiser Permanente of Northern California, Oakland, California.
David Geffen School of Medicine at UCLA/UCLA Health, Los Angeles, California.
A A Pract. 2019 Jan 15;12(2):44-46. doi: 10.1213/XAA.0000000000000840.
Pain management with opioids is often limited by medication side effects. One of the most common and distressing side effects is opioid-induced constipation (OIC), a syndrome that is now getting significant national attention. We report the case of an opioid-dependent 56-year-old man who underwent lumbar decompression for spinal stenosis. Postoperatively, he developed OIC and Ogilvie syndrome, then following treatment with methylnaltrexone experienced an acute bowel perforation. We briefly review the recommended management of OIC as well as indications and contraindications of methylnaltrexone and similar new medications.
