An Update on The Use of Pharmacotherapy for Opioid-Induced Bowel Dysfunction.

Despite the significant burden of OIBD, the clinical development of agents lags behind disease progress. Namely, although in most places, management of opioid-induced constipation (OIC) is initiated by lifestyle modifications followed by laxatives, opioid antagonists, and secretagogue agents, there are still major conflicts with significant global guidelines. The fundamental reason is the lack of head-to-head clinical trials providing inter- and intragroup comparisons between PAMORAs, laxatives, and secretagogue agents. These investigations must be accompanied by further valid biopharmaceutical and economic evaluations, paving the way for rational clinical judgment in each context.