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American Journal of Hospice and Palliative Medicine®
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Management of constipation in palliative care patients undergoing opioid therapy: Is polyethylene glycol an option?

Stefan Wirz, MD

Department of Anesthesiology and Intensive Care Medicine, Outpatient Pain Clinic, University of Bonn, Germany

Eberhard Klaschik, MD

Department of Anesthesiology, Intensive Care, Pain Therapy and Palliative Medicine, Malteser Hospital, University of Bonn, Germany

This study assessed the efficacy of laxative use for treatment of constipation in patients receiving opioid therapy, with special attention to polyethylene glycol 3350/electrolyte solution (PEG-ES). Computerized data from 206 patients were analyzed using descriptive statistics. Subgroups were analyzed using confirmatory statistics. Constipation occurred in 42.7 percent of patients. Laxatives were administered to 74.3 percent of these patients using a standardized step scheme, with good results in 78.4 percent. As a therapy for constipation, the combined administration of PEG-ES, sodium picosulphate, and liquid paraffin proved most effective, although statistical analysis yielded no significance. Early use of PEG-ES using a step scheme holds promise for treatment of opioid-related constipation in palliative care patients, although further investigation is warranted.

Key Words: constipation • opioid • laxatives • polyethylene glycol • palliative care

American Journal of Hospice and Palliative Medicine®, Vol. 22, No. 5, 375-381 (2005)
DOI: 10.1177/104990910502200511
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