ONS Guidelines™ for Opioid-Induced and Non–Opioid-Related Cancer Constipation Academic Article uri icon

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  • PURPOSE: This evidence-based guideline intends to support clinicians, patients, and others in decisions regarding the treatment of constipation in patients with cancer. METHODOLOGIC APPROACH: An interprofessional panel of healthcare professionals with patient representation prioritized clinical questions and patient outcomes for the management of cancer-related constipation. Systematic reviews of the literature were conducted. The GRADE (Grading of Recommendations Assessment, Development and Evaluation) approach was used to assess the evidence and make recommendations. FINDINGS: The panel agreed on 13 recommendations for the management of opioid-induced and non-opioid-related constipation in patients with cancer. IMPLICATIONS FOR NURSING: The panel conditionally recommended a bowel regimen in addition to lifestyle education as first-line treatment for constipation. For patients starting opioids, the panel suggests a bowel regimen as prophylaxis. Pharmaceutical interventions are available and recommended if a bowel regimen has failed. Acupuncture and electroacupuncture for non-opioid-related constipation are recommended in the context of a clinical trial. SUPPLEMENTARY MATERIAL CAN BE FOUND AT HTTPS: //bit.ly/30y29sI.


  • Rogers, Barbara
  • Ginex, Pamela
  • Anbari, Allison
  • Hanson, Brian
  • LeFebvre, Kristine
  • Lopez, Rachael
  • Thorpe, Deborah
  • Wolles, Brenda
  • Moriarty, Kerri
  • Maloney, Christine
  • Vrabel, Mark
  • Morgan, Rebecca

publication date

  • November 1, 2020