Management of Opioid-Induced Constipation in Diverticulitis Patients

Mechanism and Safety Profile

Naloxegol does not significantly increase intra-colonic pressure, which is the primary mechanical concern in diverticulitis management 1

Acetaminophen should be the primary analgesic for diverticulitis pain, but when opioids are necessary for severe pain, naloxegol provides a targeted approach to managing the inevitable constipation 2
Non-aspirin NSAIDs should be avoided in diverticulitis patients as they moderately increase the risk of diverticulitis episodes and complications, making opioids a more appropriate choice for severe pain when acetaminophen is insufficient 3, 2
Maintaining soft, regular stools is beneficial in diverticulitis to reduce straining and intra-colonic pressure, which naloxegol facilitates without the mechanical stress of stimulant laxatives 1

While osmotic laxatives like MiraLAX are also safe in diverticulitis, naloxegol offers a mechanistically superior approach for opioid-induced constipation by directly antagonizing the cause rather than simply softening stool 1