Opioid-induced bowel dysfunction: a literature review

Opioid therapy plays a crucial role in the management of acute and chronic pain, with opioids being widely prescribed worldwide. However, alongside the analgesic benefits, the use of opioids is associated with a range of adverse effects, including opioid-induced bowel dysfunction. Opioid-induced bowel dysfunction refers to a constellation of gastrointestinal symptoms caused by the effects of opioids on the gastrointestinal tract. These symptoms primarily manifest as constipation, but can also include abdominal pain, bloating, nausea, and vomiting. Opioid-induced bowel dysfunction poses a significant clinical challenge, as it can severely affect patients' quality of life. Non-pharmacological approaches alone are rarely sufficient to counteract the adverse effects of opioid therapy. The primary pharmacological agents used in opioid-induced bowel dysfunction management are laxatives, which should be chosen according to individual patient needs. Patients with poorly controlled symptoms can benefit from new pharmacological approaches, particularly peripheral mu-opioid receptor antagonists. By better understanding the underlying mechanisms, clinical manifestations, diagnostic criteria, and management strategies, healthcare professionals can optimize patient care, minimize complications, and improve patients' overall well-being

Opioid-induced bowel dysfunction: a literature review

Opioid therapy plays a crucial role in the management of acute and chronic pain, with opioids being widely prescribed worldwide. However, alongside the analgesic benefits, the use of opioids is associated with a range of adverse effects, including opioid-induced bowel dysfunction. Opioid-induced bowel dysfunction refers to a constellation of gastrointestinal symptoms caused by the effects of opioids on the gastrointestinal tract. These symptoms primarily manifest as constipation, but can also include abdominal pain, bloating, nausea, and vomiting. Opioid-induced bowel dysfunction poses a significant clinical challenge, as it can severely affect patients' quality of life. Non-pharmacological approaches alone are rarely sufficient to counteract the adverse effects of opioid therapy. The primary pharmacological agents used in opioid-induced bowel dysfunction management are laxatives, which should be chosen according to individual patient needs. Patients with poorly controlled symptoms can benefit from new pharmacological approaches, particularly peripheral mu-opioid receptor antagonists. By better understanding the underlying mechanisms, clinical manifestations, diagnostic criteria, and management strategies, healthcare professionals can optimize patient care, minimize complications, and improve patients' overall well-being

The First Guaian-12-oic Acid Glucopyranosyl Ester and Other Constituents from Picris rhagadioloides (L.) Desf. (Asteraceae)

The first guaian-12-oic acid glucopyranosyl ester was isolated from the roots ofPicris rhagadioloides (L.) Desf. (Asteraceae), in addition to five costuslactone-typeguaianolides, four germacranolides and three phenolic compounds. This is the first timethat the known phenolics syringaldehyde and syringaresinol, as well as the knownsesquiterpene lactones glucozaluzanin C, cichorioside C and hypochoeroside A have beendescribed from a Picris species. The compounds were characterized on the basis ofphysicochemical, 1D- and 2D-NMR spectroscopic, and mass spectrometric data

Root constituents of Lactuca sibirica and a comparison of metabolite profiles of L. sibirica and L. tatarica

Nine known sesquiterpene lactones, including four lactucin-type guaianolides, four costuslactone-type guaianolides and one germacranolide, were isolated from roots of Lactuca sibirica (Asteraceae), six of which were glycoside derivatives. The chemosystematic significance of the compounds is discussed in the context of sesquiterpenoids present in roots of the closely related species Lactuca tatarica. A comparison of sesquiterpene lactone profiles indicate that the species can be differentiated on the basis of their germacranolide glycoside compositions

Sesquiterpene lactones from Lactuca canadensis and their chemotaxonomic significance

A total of 19 sesquiterpene lactones were isolated from roots of Lactuca canadensis L., of which 10 were reported for the first time from Lactuca species and two were unknown. This is also the first report on the co-occurrence of three pairs of zaluzanin C-type guaianolides, epimeric at C-3, and on the presence of six eudesmanolides, oxygenated at C-1 and C-3, in Lactuca species. The new compounds were characterized as 3-epizaluzanin C-3- O - b -glucopyranoside and 11,13-dehydrolactuside C using 1D and 2D NMR and high resolution mass spectroscopy. The sesquiterpene lactone profile of this species is dominated by zaluzanin C-type guaianolides (9 compounds) and eudesmanolides (8 compounds). The dissimilarity of this profile compared to that of other taxa of the genus is discussed

Stem Lettuce and Its Metabolites: Does the Variety Make Any Difference?

The objective of the present study was to characterize chemical composition of hitherto unexamined aerial parts of Lactuca sativa var. angustana cv. Grüner Stern. In contrast to leafy and head varieties of the lettuces, asparagus lettuce grown in Europe is much less studied. Fractionation of a methanolic extract from leaves of L. sativa cv. Grüner Stern, supported with HPLC/DAD and 1H NMR analysis, led to the isolation and/or identification of numerous terpenoid and phenolic compounds, including five apocarotenoids—(-)-loliolide, (+)-dehydrovomifoliol, blumenol A, (6S,9S)-vomifoliol, and corchoionoside C; three sesquiterpene lactones; two lignans—((+)-syringaresinol and its 4-O-β-glucoside); five caffeic acid derivatives; and three flavonoids. Some of the compounds, to the best of our knowledge, have never been isolated from L. sativa before. Moreover, monolignols, phenolic acids and a tryptophan-derived alkaloid were found in the analyzed plant material. Stems, leaves and shoot tips of the asparagus lettuce were examined to assess their phenolics and sesquiterpene lactone content as well as DPPH scavenging activity. Another stem lettuce—L. sativa var. angustana cv. Karola, two cultivars of leafy lettuces and one species of wild lettuce—L. serriola, were also examined as a reference material using HPLC/DAD. The results have been discussed regarding our previous studies and the literature data available