Most patients require strong pain relief after their operations. Opioids (that is, narcotics or morphine-like medications) are usually a part of the pain management strategy postoperatively…and all medications come with side-effects.

Most postoperative pain management is multimodal – using multiple medications in small doses. The aim of that strategy is to target multiple receptors to maximise benefit and minimise side-effects.

When strong pain medication is required, it is important to identify those patients particularly at risk of constipation. Risk factors include advanced age, female sex, relative immobility, dehydration, altered nutritional intake, anal fissures and mechanical obstruction. Many of these are associated with a hospital stay…

Prevention and management of OIC includes

–       identifying patients at particular risk

–       dietary management – adequate hydration, dietary fibre

–       mobilisation – where possible

–       tailoring different types of opioids to patient needs  – and knowing that those needs change with time

–       pharmacological management: bulking agents, stool softeners, osmotic and/or stimulant laxatives.