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Opioid constipation management — GPhC CRA MCQ

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ModerateGI TherapeuticsOpioid constipation managementGPhC CRA

A 64-year-old woman taking oxycodone modified-release after surgery asks for help with constipation. She has abdominal discomfort, hard stools and no vomiting; she is taking senna at night but no osmotic laxative. What is the most appropriate alternative?

Educational content. Not a substitute for clinical judgement or local policy.

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Correct answer: A — Add an osmotic laxative and review response, with escalation if symptoms worsen

Opioid constipation often requires regular laxative therapy, commonly combining stimulant and osmotic approaches if needed. The absence of vomiting or severe distension makes community management reasonable, but deterioration would require urgent review. Loperamide would worsen constipation. Bulk-forming laxatives may be less suitable if fluid intake is poor or obstruction is suspected.

Reference: BNF; NICE CKS Constipation