Opioids are increasingly used to reduce severe chronic and acute non-cancerous pain, including spinal osteoarthritis, failed back surgery, and back pain. However, adverse gastrointestinal effects potentially reduce the clinical utility of opioids. Generally, 40–95% of patients using opioids develop opioid-induced constipation (OIC). It is the most common side effect of opioids, as tolerance does not arise over the long term, in contrast to what is observed with other symptoms such as vomiting, sedation, and nausea. OIC can occur at any time after the initiation of opioid analgesics, and will negatively affect a patient’s quality of life, psychological wellbeing, work productivity, and daily activity. The symptoms of OIC are similar to those of functional constipation. 

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