Constipation during analgesic therapy with opioid drugs is the most common side effect and a big problem among cancer patients, the basis for the treatment of cancer pain is pharmacotherapy complex with opioid analgesics and supportive drugs, according to the principles of the WHO analgesic ladder. The CBD Suppositories works perfectly there.
In addition to painkillers, opioids act through their receptors in the gastrointestinal tract (they cause weakness of bowel movements), nervous system (cause dizziness, drowsiness, fatigue, sedation, loss of appetite, euphoria, irritability, convulsions), cardiovascular system (lowering blood pressure), respiratory system (reduction of breathlessness and cough reflex) and in the skin (pruritus, sweating).
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The effect of opioids is on the digestive system results both from their central action, through the central nervous system and peripheral directly on the intestinal nervous system. Spasms of the small and large intestine are inhibited, prolonging the passage time of the digestive content. In addition, the absorption of water from the intestinal lumen increases, which leads to the formation of dry faeces and increases the tension of the anal sphincters, leading to the retention of hard, difficult to expel fecal masses. As a result of opioid receptor activation, gastric motions are also suppressed, which leads to longer emptying time.
In contrast to the symptoms of other systems and organs (drowsiness, nausea, vomiting), with respect to constipation due to opioids, there is no tolerance or tendency to disappear with the use of drugs from this group. On the contrary, the incidence of constipation increases with the duration of therapy with morphine and its derivatives.
- Drugs from the group, as they differ in their strength of analgesia, also disturb the gastrointestinal motility.
- The route of administration of opioid drugs is important in predicting their effect on the gastrointestinal tract.
- For example, fentanyl in the form of patches significantly disturbs gastrointestinal motility than oral morphine, although fentanyl works more strongly and gives a better analgesic effect in chronic treatment.
There is no definite relationship between the dose of opioid and the incidence and intensity of constipation. The differences seem to be individual and individual: in some patients, low doses of opioids result in constipation, while in others, they are not observed for a long time.
Regardless of the dose and preparation used, it is recommended to educate patients starting opioid therapy and prevention against paralysis. The increase in adverse effects of the taken preparations is inextricably associated with less tolerance of therapy, deterioration of the patient’s quality of life and less analgesic effect of the drug due to the fear of intensification after the next or higher dose of the drug.
- It is essential that if you experience the first symptoms of constipation or appear, please tell your doctor.
Today, there are many simultaneously used methods to alleviate this ailment. These include, for example, changing your current diet, lifestyle, including supportive therapies, or changing one opioid to another. It is worth remembering all of this when contacting your doctor. If we know that we can improve the quality of our lives, we should make every effort to achieve this goal.