Managing Opioid Induced Constipation
Opioid medications are frequently used to help manage pain – both acute pain and chronic pain. While they are very effective at pain relief, that relief can come with a price. Opioids have side effects and many of them are related to the gastrointestinal system.
One side effect is the slowing down of the gut leading to constipation. This is the most common side effect and also one of the most debilitating. While other side effects may go away with time, constipation tends to be a side effect that stays present even with long-term use. (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4772344/)
So how can you manage when constipation becomes a problem?
There are two different approaches – those that use medications and those that don’t. Both can be effective tools in managing this problem and helping you to get back to a normal bathroom schedule.
The approach that doesn’t use medications typically involves practicing a good schedule of going to the bathroom. Many people ignore the urge to go to the bathroom until a later time and doing so will increase constipation when using opioids.
It can also be helpful to look at lifestyle factors. Not drinking enough water or eating enough fiber can contribute to constipation in anyone. So if you’re not drinking an adequate amount of water to begin with, this could help.
However, if you’re already someone who drinks adequate water and eats adequate fiber, adding more isn’t likely to help constipation caused by opioid drugs. In fact, eating too much fiber can actually make the problem worse and even lead to a bowel obstruction.
Instead, it may be necessary to begin a regimen of medications to help with this type of constipation. There are several options you can try by working with your physician and determining what makes the most sense.
One of the simplest choices is mineral oil. Mineral oil helps to lubricate the intestines and keep the colon from absorbing more water from the stool. While mineral oil is typically safe, it can cause complications.
The most significant is choking. To avoid choking, it’s important to take mineral oil in an upright position and to stay upright for at least 30 minutes after taking it. Mineral oil taken long term can also make it hard for your body to absorb fat-soluble vitamins. It’s important to have blood tests to confirm adequate vitamin levels.
Stool softeners work in a similar way. They help the body to add more water and fat to the stool so that it can pass more effectively. This is a very safe choice and is readily available over the counter.
Drugs note as osmotics work to add more water into the bowel. They can be taken orally or rectally. They are also available over the counter. These should be used with caution as they can cause excessive loss of fluids.
Stimulants can also be purchased over the counter to treat constipation. They cause the muscles of the intestines to move so that the waste can be pushed through the system.
Finally, if none of the over the counter remedies work there are prescription medications available that can block some of the effects of opioid medications and restore normal bowel function. It’s important to discuss options with your healthcare provider if you suffer from opioid induced constipation.