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Opioid-induced constipation — GPhC CRA MCQ

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ModerateCNS TherapeuticsOpioid-induced constipationGPhC CRA

A 44-year-old man takes morphine modified-release 30mg twice daily for cancer pain and senna two tablets at night. He now has hard stools every four days despite drinking normally and has no vomiting or abdominal distension. What is the most appropriate alternative?

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

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Correct answer: E — Optimise regular laxative treatment and assess for red flags or obstruction.

Opioid-induced constipation is common and usually requires regular stimulant and/or osmotic laxative treatment. The absence of vomiting or distension makes obstruction less likely, but red flags should still be assessed. Abrupt opioid cessation in cancer pain is inappropriate without a pain plan.

Reference: BNF; NICE CKS