Which strategy is appropriate for preventing opioid-induced constipation?

• A. Accept constipation as side effect
• B. Initiating stool softeners or laxatives
• C. Use only laxatives
• D. Increase opioid dose

Answer: (B)

Preventing opioid-induced constipation is best done by starting a bowel regimen at the same time as the opioid therapy. Opioids slow gut motility and increase water absorption, so constipation can develop quickly and often persists despite time or dose changes. Using stool softeners or laxatives proactively helps keep stool softer and promotes bowel movements, addressing the main problem rather than just reacting after symptoms appear. Increasing the opioid dose would worsen constipation, and simply accepting it as inevitable isn’t a strategy. Relying on laxatives alone can be insufficient because the underlying motility slowing may require a combination approach (softeners plus stimulant or osmotic laxatives). So initiating stool softeners or laxatives from the outset provides proactive management aligned with how opioids affect the gut.