Opioid medications are commonly used in clinical practice and have acute or chronic effects on diverse parts of the gastrointestinal tract. Because of their widespread use, it is imperative to consider whether any presentation with gastrointestinal symptoms may be related to the intake of opioids. Acute administration of opioids should be accompanied by symptomatic remedies to counter the acute pharmacologic effects, and these include antiemetics and laxatives. The bowel function index (BFI) (pictured below) is a useful clinical tool to identify chronic opioid-induced constipation (OIC) that is not responding satisfactorily to first-line therapies and to select patients for treatment with prescription medications approved for the treatment of OIC.
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