Published in 2018 - Ann Oncol (2018) 29 (Suppl 4): iv111–iv125
Authors: P. J. Larkin, N. I. Cherny, D. La Carpia, M. Guglielmo, C. Ostgathe, F. Scotte & C. I. Ripamonti, on behalf of the ESMO Guidelines Committee
Constipation is a common subjectively experienced problem and a significant source of major morbidity and distress. The 2018 ESMO Clinical guidelines on Diagnosis, assessment and management of constipation in advanced cancer update evidence in relation to strategies for management. Opioid analgesics for cancer pain pose specific challenges for constipation management. A recommendation for the use of peripherally-acting mu-opioid receptor antagonists (PAMORAS) including prolonged-released formulations in the management of refractory constipation is included.