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For patients with advanced cancer, constipation is a common problem that can cause a number of distressing symptoms including abdominal pain, distention, nausea, and anorexia. For most patients, aggressive bowel regimens with stool softeners and laxatives ameliorate symptoms, but for others, problems persist. Constipation can be caused by a number of factors such as mechanical obstruction, metabolic abnormalities, neurologic dysfunction, or drug-related effects, particularly bowel dysfunction associated with opioid analgesics. Because opioid-induced bowel dysfunction is thought to be mediated by peripheral μ receptors, whereas pain control is mediated primarily by central μ receptors, isolated blockade of peripheral μ receptors might be a p…