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Am Fam Physician. 2023;107(2):131-132

Author disclosure: No relevant financial relationships.

Details for This Review

Study Population: 1,343 adults in 10 randomized controlled trials who have cancer (any stage) or are receiving palliative care (any terminal disease)

Efficacy End Points: Laxation response

Harm End Points: Effect on analgesia and adverse events

GreenBenefits greater than harms
YellowUnclear benefits
RedNo benefits
BlackHarms greater than benefits

Narrative: Opioids are often used to manage moderate to severe pain in patients with cancer and patients with or without cancer receiving palliative care. The benefit of opioid analgesics occurs through binding to mu-, kappa-, and delta-opioid receptors. Activation of mu-opioid receptors in the wall of the gut leads to disruption of gastrointestinal propulsive motility, causing decreased peristalsis, delayed gastric emptying, and ultimately opioid-induced bowel dysfunction, a significant adverse effect of opioid use.1

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This series is coordinated by Christopher W. Bunt, MD, AFP assistant medical editor, and the NNT Group.

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