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Constipation caused by moderate effects on severe pain medications (opioids)

The use of opioids in the treatment of pain is becoming more common. True reference to help, however, they cause undesirable side effects, among which constipation is the most common.
This constipation is called opioid-induced constipation because it is of medicinal origin and therefore requires special treatment.

Headaches, back pains, sciatica, fibromyalgia, rheumatism, cancer pain, postoperative pain or other pain from moderate to severe, many of which can lead to the administration of opioid analgesics (such as codeine or tramadol – opioids). so-called weak, but also stronger morphine, such as morphine, oxycodone or fentanyl).

Various pain relief plans have led to better pain management in France, a real need for health care.

But who says that the increased use of opioid analgesics also indicates an increase in the undesirable effects associated with these pain medications, of which constipation is the most frequent (long before nausea, drowsiness or confusion).
This constipation is largely underestimated because the patient does not necessarily speak (by modesty or habit). Indeed, according to studies, up to 94% of patients taking opioids are concerned.

– On mild opioids, such as codeine or tramadol, on average 1/3 of patients are constipated.
– From strong opioids, such as morphine, constipation occurs in 2/3 of patients.
18.2% of the French received at least one opioid analgesic prescription in 2015.

In a recent survey conducted in 2014, 60% of 513 patients preferred to reduce the dose of analgesics due to constipation. Others preferred to temporarily or even permanently discontinue opioid therapy.
Thus, constipation can affect the quality of pain treatment for a patient.

Constipation caused by opioids can cause a number of symptoms: fatigue, insomnia, gas, bloating, discomfort in the lower abdomen … but also reflux or loss of appetite.

These symptoms, which have a very negative effect on the patient’s quality of life, constitute a barrier to daily activities, whether personal or professional; These symptoms cause:
– a significant increase in the number of consultations (emergency care, specialists)
– an increase in the number of hospitalizations with an increased average length of stay with certain assistance and an increase in their value.

To cure this obtrusive syndrome for a patient, it is recommended that you systematically prescribe a laxative when you first take opioid therapy. This recipe is used to inform the patient about this undesirable side effect, which may occur in addition to treatment if necessary. However, in 50% of cases, patients do not respond satisfactorily, and laxatives are ineffective.

That is why this type of constipation requires special and adapted treatment, which has a pharmacological and non-mechanical cause.

Until now, an unknown or unknown opioid-induced constipation has been the subject of clinical studies for several years.

Knowing that laxatives are not effective enough for half of the patients taking opioid analgesics (using enemas, feeling of incomplete evacuation …), new molecules were developed: PAMORA (short for opioid receptor antagonists). peripheral, namely gastrointestinal).
A pharmacological response is required to solve a pharmacological problem (constipation associated with an opioid).

Indeed, analgesics (weak or strong morphines) act on the central nervous system (central nervous system), as well as on the level of SNE (intestinal nervous system) on the digestive system, which is currently considered the second brain, where about 200 million neurons, among other things, sit .

Therefore, taking opioids can result (in parallel with pain relief):
– slowing the motility of the gastrointestinal tract
– no mucous secretions
– dysfunction in sphincters
→ These 3 effects cause immediate constipation.

This new therapeutic class of PAMORA acts locally (at the level of the gastrointestinal tract), displacing opioids fixed on µ-morphine receptors to counteract constipation and the resumption of intestinal transit.

Summarizing, we can say that PAMORA specifically focuses on the causes of constipation caused by weak and strong morphine analgesics for quick efficacy and, thus, allows the patient to follow the pain therapy well without changing the quality of his life: you need to limit the dose more to avoid constipation: no longer has to “choose” between pain or constipation.

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statement Published 2019-02-06 11:56:34 through in the Health section

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