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Opioids and Constipation

Florida Pain Centers –

Opioids and ConstipationOpioids, or narcotics, are commonly used medications and are a cornerstone treatment for acute, as well as, chronic pain. While there are benefits to using an opioid, such as vicodin, they are often responsible for many undesirable effects. One of the more common side effects of narcotic pain medications is constipation.

Patients can become tolerant to some side effects of narcotics; however, constipation can remain problematic in a patient engaged in chronic, or even short-term, narcotic therapy. Narcotics exact their constipating effect by slowing normal gastrointestinal function. Opioid-induced constipation can be a significant problem resulting in a decreased quality of life and needs to be treated aggressively to prevent bowel obstruction.

There are many ways to treat opioid-induced constipation. Initial treatments include increasing intake of dietary fiber. However, it is important to also increase intake of fluids. An increase in dietary fiber without an increase in fluids can perpetuate constipation. Other important treatments include stool softeners and laxatives.

Stool softeners such as colace work by reducing the surface tension and help create softened, more lubricated stools. While stool softeners are useful in combating constipation, they are often not sufficient and laxatives are usually combined with stool softeners to produce a greater effect. Commonly used laxatives include Milk of Magnesia (MOM), Miralax, Dulcolax, and Senna.

Patients with constipation refractory to oral agents may need an enema or a suppository. If you are suffering from opioid-induced constipation, it is important to discuss the appropriate treatment with your physician.

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