What would be the best course of action for a patient experiencing opioid-induced constipation?

Starting a stimulant laxative is the best course of action for a patient experiencing opioid-induced constipation because stimulant laxatives, such as bisacodyl or senna, are specifically designed to increase bowel activity. Opioids can slow down gastrointestinal transit and decrease the secretion of fluids into the intestines, leading to constipation. Stimulant laxatives work by directly stimulating the nerve endings in the intestinal wall, enhancing motility and promoting bowel movements.

This approach addresses the constipation effectively while allowing for the continued use of opioids for pain management. Other treatments, such as peripherally acting μ-opioid receptor antagonists, can also be effective; however, they may not be the first choice in every clinical scenario and may require more careful monitoring and potential cost considerations. Options that involve changing the opioid dose, either increasing or decreasing, are not suitable as they do not directly address the constipation problem and can lead to inadequate pain control or worsening of side effects.