ONS Guidelines™ for Opioid-Induced and Non-Opioid-Related Cancer Constipation.

PURPOSE: This evidence-based guideline intends to support clinicians, patients, and others in decisions regarding the treatment of constipation inpatients 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 suggestsabowel 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.