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Opioid-Induced Gastrointestinal Dysfunction (OGD): A Questionnaire Survey of Chronic Opioid Users

Spierings ELH*

In order to gain insight into the symptoms of opioid-induced gastrointestinal dysfunction, we conducted a questionnaire survey among 119 daily prescription-opioid users, also to understand how they deal with the dysfunction, with or without physician assistance, using the abundantly available, over-the-counter constipation remedies. Almost 80% had constipation, as opposed to almost 20% before taking opioids, and more than 60% had constipation despite the use of constipation remedies. More than half had bowel movements 1 to 3 times per week, which was the case in slightly over 20% before taking opioids. Despite the use of constipation remedies, straining, incomplete evacuation, rectal impaction, and hard stool were common. Of these symptoms, hard stool was considered to be the most bothersome, followed by flatulence, abdominal discomfort/pain, false alarm, and abdominal bloating. Relatively serious complications of the constipation, such as hemorrhoids, anal fissures, rectal impaction, and rectal prolapse, were reported by 20% to 40% of patients. Of the stomach symptoms per se, anorexia and acid reflux were relatively common, warranting the term opioid-induced gastrointestinal dysfunction.