{"title":"阿片类药物引起的便秘在内科：识别和管理途径。","authors":"Piero Portincasa, Chiara Valentina Luglio, Silvia Sozzi, Claudia Conforti, Gianluca Bitonto, Michele Papavero, Gyorgy Baffy, Agostino Di Ciaula","doi":"10.1007/s11739-025-04091-2","DOIUrl":null,"url":null,"abstract":"<p><p>Opioid-induced constipation (OIC) remains one of the most frequent and distressing gastrointestinal side effects encountered by patients on chronic opioid therapy. Despite the high prevalence, OIC is frequently underdiagnosed and inadequately managed, with critical effects on the quality of life of patients. Aim of this review is to promote the awareness about OIC in the context of internal medicine. We examined the statement EnhanCing Healthcare Outcomes in Opioid-Induced Constipation (ECHO OIC) by European experts to streamline the diagnosis and management of OIC in clinical practice. Such guidelines have been further discussed by an Italian expert consensus to provide national customization and a multidisciplinary approach. The key finding is the implementation of a multi-step clinical pathway for prevention, diagnosis, treatment, and long-term management of OIC, taking into account the improvement of quality of life of patients. In conclusion, we urge to expand awareness about OIC. The seven-step diagnostic-therapeutic pathway approach formulated by ECHO OIC is a pragmatic and scalable model to improve OIC management with emphasis on education, early intervention, monitoring, tailored pharmacologic strategies, and coordinated referral when necessary.</p>","PeriodicalId":13662,"journal":{"name":"Internal and Emergency Medicine","volume":" ","pages":"1695-1704"},"PeriodicalIF":3.8000,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12476432/pdf/","citationCount":"0","resultStr":"{\"title\":\"Opioid-induced constipation in internal medicine: recognition and management pathways.\",\"authors\":\"Piero Portincasa, Chiara Valentina Luglio, Silvia Sozzi, Claudia Conforti, Gianluca Bitonto, Michele Papavero, Gyorgy Baffy, Agostino Di Ciaula\",\"doi\":\"10.1007/s11739-025-04091-2\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><p>Opioid-induced constipation (OIC) remains one of the most frequent and distressing gastrointestinal side effects encountered by patients on chronic opioid therapy. Despite the high prevalence, OIC is frequently underdiagnosed and inadequately managed, with critical effects on the quality of life of patients. Aim of this review is to promote the awareness about OIC in the context of internal medicine. We examined the statement EnhanCing Healthcare Outcomes in Opioid-Induced Constipation (ECHO OIC) by European experts to streamline the diagnosis and management of OIC in clinical practice. Such guidelines have been further discussed by an Italian expert consensus to provide national customization and a multidisciplinary approach. The key finding is the implementation of a multi-step clinical pathway for prevention, diagnosis, treatment, and long-term management of OIC, taking into account the improvement of quality of life of patients. In conclusion, we urge to expand awareness about OIC. The seven-step diagnostic-therapeutic pathway approach formulated by ECHO OIC is a pragmatic and scalable model to improve OIC management with emphasis on education, early intervention, monitoring, tailored pharmacologic strategies, and coordinated referral when necessary.</p>\",\"PeriodicalId\":13662,\"journal\":{\"name\":\"Internal and Emergency Medicine\",\"volume\":\" \",\"pages\":\"1695-1704\"},\"PeriodicalIF\":3.8000,\"publicationDate\":\"2025-09-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12476432/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Internal and Emergency Medicine\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1007/s11739-025-04091-2\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2025/8/28 0:00:00\",\"PubModel\":\"Epub\",\"JCR\":\"Q1\",\"JCRName\":\"MEDICINE, GENERAL & INTERNAL\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Internal and Emergency Medicine","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1007/s11739-025-04091-2","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2025/8/28 0:00:00","PubModel":"Epub","JCR":"Q1","JCRName":"MEDICINE, GENERAL & INTERNAL","Score":null,"Total":0}
Opioid-induced constipation in internal medicine: recognition and management pathways.
Opioid-induced constipation (OIC) remains one of the most frequent and distressing gastrointestinal side effects encountered by patients on chronic opioid therapy. Despite the high prevalence, OIC is frequently underdiagnosed and inadequately managed, with critical effects on the quality of life of patients. Aim of this review is to promote the awareness about OIC in the context of internal medicine. We examined the statement EnhanCing Healthcare Outcomes in Opioid-Induced Constipation (ECHO OIC) by European experts to streamline the diagnosis and management of OIC in clinical practice. Such guidelines have been further discussed by an Italian expert consensus to provide national customization and a multidisciplinary approach. The key finding is the implementation of a multi-step clinical pathway for prevention, diagnosis, treatment, and long-term management of OIC, taking into account the improvement of quality of life of patients. In conclusion, we urge to expand awareness about OIC. The seven-step diagnostic-therapeutic pathway approach formulated by ECHO OIC is a pragmatic and scalable model to improve OIC management with emphasis on education, early intervention, monitoring, tailored pharmacologic strategies, and coordinated referral when necessary.
期刊介绍：
Internal and Emergency Medicine (IEM) is an independent, international, English-language, peer-reviewed journal designed for internists and emergency physicians. IEM publishes a variety of manuscript types including Original investigations, Review articles, Letters to the Editor, Editorials and Commentaries. Occasionally IEM accepts unsolicited Reviews, Commentaries or Editorials. The journal is divided into three sections, i.e., Internal Medicine, Emergency Medicine and Clinical Evidence and Health Technology Assessment, with three separate editorial boards. In the Internal Medicine section, invited Case records and Physical examinations, devoted to underlining the role of a clinical approach in selected clinical cases, are also published. The Emergency Medicine section will include a Morbidity and Mortality Report and an Airway Forum concerning the management of difficult airway problems. As far as Critical Care is becoming an integral part of Emergency Medicine, a new sub-section will report the literature that concerns the interface not only for the care of the critical patient in the Emergency Department, but also in the Intensive Care Unit. Finally, in the Clinical Evidence and Health Technology Assessment section brief discussions of topics of evidence-based medicine (Cochrane’s corner) and Research updates are published. IEM encourages letters of rebuttal and criticism of published articles. Topics of interest include all subjects that relate to the science and practice of Internal and Emergency Medicine.
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