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Peer-reviewedCC BY-NC-NDJournal of Gastrointestinal and Liver Diseases

A Pilot Real-life Study Opioid Induced Constipation in Neoplastic Patients Admitted to Internal Medicine Ward. Outcome of Naldemedine Therapy According to Available Guidelines

  • Chiara Valentina Luglio1
  • Agostino Di Ciaula2
  • Silvia Sozzi3
  • Claudia Conforti4
  • Gianluca Bitonto5
  • Piero Portincasa6
  • OIC-BA Study Group7
7 affiliations
  1. 1Division of Internal Medicine 'A. Murri' and Department of Precision and Regenerative Medicine and Ionian Area (DiMePre-J), University of Bari 'Aldo Moro'. [email protected]
  2. 2Division of Internal Medicine "A. Murri" and Department of Precision and Regenerative Medicine and Ionian Area (DiMePre-J), University of Bari Aldo Moro, Bari, Italy. [email protected]
  3. 3Division of Internal Medicine 'A. Murri' and Department of Precision and Regenerative Medicine and Ionian Area (DiMePre-J), University of Bari 'Aldo Moro'. [email protected]
  4. 4Division of Internal Medicine 'A. Murri' and Department of Precision and Regenerative Medicine and Ionian Area (DiMePre-J), University of Bari 'Aldo Moro'. [email protected]
  5. 5Division of Internal Medicine 'A. Murri' and Department of Precision and Regenerative Medicine and Ionian Area (DiMePre-J), University of Bari 'Aldo Moro'. [email protected]
  6. 6Division of Internal Medicine 'A. Murri' and Department of Precision and Regenerative Medicine and Ionian Area (DiMePre-J), University of Bari 'Aldo Moro'. [email protected]
  7. 7Anna Belfiore, Pierluigi Carratu, Carlo Custodero, Angela De Luca, Tecla Diana, Antonio Giuliano, Antonino Noto, Anna Romito. [email protected]
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Abstract

BACKGROUND AND AIMS: The use of opioids has expanded significantly worldwide in patients with cancer-related pain. Therefore, opioid-induced constipation (OIC) is emerging as one of the most frequent and distressing gastrointestinal side effects. Despite the high prevalence, OIC is frequently underdiagnosed and inadequately managed, with critical effects on the quality of life of patients. METHODS: The present study assessed the real-life prevalence of opioid use and OIC in 316 consecutive cancer patients hospitalized in an Internal Medicine ward and evaluated the outcomes following PEG or naldemedine during hospitalization. When OIC was diagnosed (Rome IV criteria), all patients underwent polyethylene glycol (PEG). Naldemedine was subsequently administered in refractory OIC. RESULTS: A total of 82 patients (26% of admissions) were assuming opioids for cancer pain, with constipation diagnosed in 62% and 24% of patients with or without opioid treatment, respectively. The risk of OIC was higher during combined opioids than in monotherapy, and fentanyl was associated with the highest OIC prevalence. Among patients with OIC, 47% responded to polyethylene glycol (PEG), whereas 52.9% started naldemedine 200 micrograms/day for a refractory OIC, with subsequent improvement in 59.3% of cases. CONCLUSIONS: The prevalence of opioid use and OIC is relevant among hospitalized cancer patients. The systematic adoption of standardized diagnostic tools can improve recognition and the clinical management in patients with OIC, in particular in case of refractory OIC. It is essential to increase awareness on this condition and to implement management pathways based on existing guidelines.

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Cite

BibTeXRIS
BibTeX
@article{luglio2026pilot,
  title = {{A Pilot Real-life Study Opioid Induced Constipation in Neoplastic Patients Admitted to Internal Medicine Ward. Outcome of Naldemedine Therapy According to Available Guidelines}},
  author = {Chiara Valentina Luglio and Agostino Di Ciaula and Silvia Sozzi and Claudia Conforti and Gianluca Bitonto and Piero Portincasa and OIC-BA Study Group},
  journal = {Journal of Gastrointestinal and Liver Diseases},
  year = {2026},
  month = jun,
  doi = {10.15403/jgld-6733},
  url = {https://doi.org/10.15403/jgld-6733},
  note = {CC BY-NC-ND},
}
RIS
TY  - JOUR
TI  - A Pilot Real-life Study Opioid Induced Constipation in Neoplastic Patients Admitted to Internal Medicine Ward. Outcome of Naldemedine Therapy According to Available Guidelines
AU  - Chiara Valentina Luglio
AU  - Agostino Di Ciaula
AU  - Silvia Sozzi
AU  - Claudia Conforti
AU  - Gianluca Bitonto
AU  - Piero Portincasa
AU  - OIC-BA Study Group
PY  - 2026
DA  - 2026/06/26
JO  - Journal of Gastrointestinal and Liver Diseases
DO  - 10.15403/jgld-6733
UR  - https://doi.org/10.15403/jgld-6733
AB  - BACKGROUND AND AIMS: The use of opioids has expanded significantly worldwide in patients with cancer-related pain. Therefore, opioid-induced constipation (OIC) is emerging as one of the most frequent and distressing gastrointestinal side effects. Despite the high prevalence, OIC is frequently underdiagnosed and inadequately managed, with critical effects on the quality of life of patients. METHODS: The present study assessed the real-life prevalence of opioid use and OIC in 316 consecutive cancer patients hospitalized in an Internal Medicine ward and evaluated the outcomes following PEG or naldemedine during hospitalization. When OIC was diagnosed (Rome IV criteria), all patients underwent polyethylene glycol (PEG). Naldemedine was subsequently administered in refractory OIC. RESULTS: A total of 82 patients (26% of admissions) were assuming opioids for cancer pain, with constipation diagnosed in 62% and 24% of patients with or without opioid treatment, respectively. The risk of OIC was higher during combined opioids than in monotherapy, and fentanyl was associated with the highest OIC prevalence. Among patients with OIC, 47% responded to polyethylene glycol (PEG), whereas 52.9% started naldemedine 200 micrograms/day for a refractory OIC, with subsequent improvement in 59.3% of cases. CONCLUSIONS: The prevalence of opioid use and OIC is relevant among hospitalized cancer patients. The systematic adoption of standardized diagnostic tools can improve recognition and the clinical management in patients with OIC, in particular in case of refractory OIC. It is essential to increase awareness on this condition and to implement management pathways based on existing guidelines.
SN  - 1221-4167
SN  - 1841-8724
SN  - 1842-1121
ER  -