Impact and Consequences of Opioid-Induced Constipation: A Survey of Patients

Giustino Varrassi, Vivek Banerji, Walter Gianni, Franco Marinangeli, Carmine Pinto

Research output: Contribution to journalArticlepeer-review


Introduction: Opioids are a valuable tool to help achieve control of pain. However, opioid-induced constipation (OIC) is an important limitation of treatment with this class of drugs. Methods: To better understand the impact of OIC on patient-reported outcomes, we carried out a survey involving patients being treated with opioids. Both ad hoc questions and the PROMIS and PAC-SYM and PAC-QOL scores were used. Results: Of the 597 participants, 150 (25%) had cancer-related pain, and 447 (75%) had non-cancer pain; 66% experienced OIC. PROMIS pain interference questions indicated that pain is more likely to interfere with a patient’s life when they have OIC. PAC-QOL and PAC-SYM revealed that 58% of patients with non-cancer pain and OIC reported at least one “severe” or “very severe” constipation symptom, compared to 83% with cancer-related pain. Younger age and less time on opioids were associated with greater impact of OIC on quality of life. Only 41% of patients were satisfied with how their constipation was managed. Over 50% of those with non-cancer pain said that they modified their opioid regimen due to constipation, vs. 6% of those with cancer pain. Constipation had been discussed with the healthcare provider (HCP) in 48% of non-cancer patients and in 73% of cancer patients. In those with chronic pain and OIC, 24% expressed varying degrees of dissatisfaction with the healthcare system, vs. 37% in those with cancer pain and OIC. Conclusion: Our results provide additional evidence that management of OIC is inadequate in many cases. Moreover, they indicate that there is a definite need for better education about OIC among HCPs.

Original languageEnglish
JournalPain and Therapy
Publication statusAccepted/In press - 2021


  • Cancer
  • Impact
  • Opioid-induced constipation
  • Opioids
  • Pain
  • Survey

ASJC Scopus subject areas

  • Clinical Neurology
  • Anesthesiology and Pain Medicine


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