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Opioid-induced constipation red flags — GPhC CRA MCQ

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HardGastro-intestinal TherapeuticsOpioid-induced constipation red flagsGPhC CRA

A patient taking morphine modified-release 60mg twice daily asks for constipation advice. He has not opened his bowels for 4 days despite senna two tablets at night and has colicky abdominal pain with vomiting. What is the most appropriate action?

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Correct answer: B — Refer urgently for assessment because bowel obstruction or severe constipation is possible

Opioid-induced constipation is common, but vomiting and colicky abdominal pain raise concern for severe constipation or obstruction. Urgent clinical assessment is needed rather than simple laxative escalation. Loperamide would worsen constipation. Abruptly stopping high-dose morphine may cause withdrawal and uncontrolled pain.

Reference: BNF; NICE CKS Constipation