Opiod Constipation
 

I used to be so regular, twice a day without fail, but now that I've been taking Vicodin and Tramadol for PN pain I'm lucky to go every three days.
Sometimes it feels like I'm giving birth.
My diet is low in carbs, mostly fruits and veges, oatmeal for breakfast every morning. Since the constipation hit I've been taking Medamusil three times day, it seems to help things pass easier but doesn't help with regularity.

Anyone here have any tricks they'd like to share to help alleviate this common problem?

Please...
 

Bulk forming laxatives are NOT recommended for opioid constipation.

You need a stimulating or saline type.

Stimulating== peri-colace, or Dulcolax

Saline type== Miralax or magnesium supplements.

Use of fiber or bulk inducing types may lead to impaction.

Long term use of senna products can lead to changes in the bowel lining and there are worries of cancer from that.

Some people eat alot of prunes and dates..this may help if mild. Dates and prunes are nutritious in other ways as well.

Some people find a tablespoonful of extra virgin olive oil helps.

I take Tramadol & Lyrica and have had constipation issues
since starting the Lyrica.
I have been taking Tramadol for over 6 yrs, but only
found issues in the past 1-1/2 since the Lyrica.
I found 'Fiber Sure' to be most helpful. I tried Metamucil and the other fiber products, but this is the most helpful.
It is only one heaping tsp 2-3 times per day (I only take it 2x/day)
Also, I east 'Fiber Free' granola bars (9 grams per bar) as snacks with coffee in the a.m. & at lunch.

Hi Sally, just simply sipping hot water, just boil the water as if if your going to make a coffee & poor it into a cup but " don't add anything ", then when its cool enough sip it until finished, it may take a few cups, depends on each person, also " Slippery Elm " from your health shop helps as well.
good luck
Brian :)

I've had the same problem
 

with just very occasional use of opiods for non PN pain (post surgical and for a herniated cervical disk causing extreme muscle cramping). Thank you for bringing up the topic.

Yes there are many things to do?
 

But, this is ONE time to not forget LARGE QUANTITIES OF WATER! All the oils and gel-like stuffs and fibres won't work for diddley if you don't have a bit or a lot of extra water to help 'loosen' things up. YOu will have to find the balance here.
I speak from experience....the hard way [bad pun, can't help it?] In that w/my PN onset I was totally stopped up for WEEKS. It is a symptom of my diagnosis [tho after the fact - gee thanks-NOW ya tell me?]
Colace, peri-colace are pretty gentle PLUS water, and lite foods, broths lite soups etc until things happen have worked for me in the long run. And, they do take TIME. BUT this is not something you can force. Even tho you feel you mite explode? As long as gas is coming out, the rest will come when 'ready'. To over-work at it only adds stress to you. Soo tell yourself, if you've got gas? IT's good!? I've not exploded yet.
Everyone has given you good advice and each set of suggestions is definitely worth a try. The oil and warm water ones have helped me at times, so do your own trial/error experiment and go for it? HUGS - j

the hot water is a good idea or if you want drink 4 or five cups of coffee

post by ada
 

this was posted by ada on the rsd forum. i thought it might help. :hug:

My situation might be a bit different. I am not AT ALL allowed to take a stimulating laxative. Colace and Miralax will help BUT it causes my IBS to flare. Soooo....I think Dahlek hit the nail on the head. The REAL key is water and LOTS of it. I was taking Nexium, do take Vicodin and also take Klonopin. All 3 are constipating. ALL of my docs have said fiber and water. However, you have to expirement to find the right amount. At first I did take Miralax and it straightened me out but my Urogyn did NOT want me on it for very long (female issues as well as IBS). But then I switched right over to Benefiber and again, a LOT of water. All I need now is 1/8 of a tsp. and I am good to go...regularly...every morning like clockwork. :)

Thanks for the reminders!
 

Curious? That 'prune paste' thing was running thru my mind...It's been posted what seems like everywhere! I've not had to resort to it, just chilling out, water and peri-colace have done the job. I know folks who swear by it tho!
There are lots of variations of it, and I probably should keep all the ingredients on hand. SIGH!

Another key thing to do? IS walk! Even little bits! That moving well,? Helps get things moving. IF you are capable, go to the grocery store and DO one lap around the perimiter before doing your regular shopping. This is the kind of little thing that can pay off in the long run. [Just in case? Be sure to know where the public restrooms are tho....never can tell]

Just try not to force issues, you will only exhaust yourself and stress yourself unnecessarily. With PN stuff, you don't need to add other extra problems! Once things start working, do not be surprised about some aspects running 'hot' and 'cold'. Honestly I don't know how other to put it tactfully? It's at times such as these, that HOW the human body works and all truly amazes me! [Mind you, I've been constipated for up to 3-1/2 weeks and actually LOST weight!] So be calm and try the variety of things offered here and wait. REALLY - :hug:!'s - j

PS Kathi? - I have been wondering about Benefiber...I think it's something I'm gonna keep on my shelf! -j

:hug: j, from what others have said, they use it like jam/jelly.

always worth a try to do things a more natural way....with LOTS of water every day.

Dahlek,

Benefiber has always worked well for me. More recently (long story) my Gastro wanted me to try Fibercon...capsules. Oh, boy, talk about bloating! Anyway, I stopped that and went right back to the good ole Benefiber. And I should add, I know taking fiber CAN cause further constipation with high doses of the opiates. I do try to eat some kind of fiber cereal too; about every other day. The deal I experienced with Miralax (prescription at the time) was that I was told to take 17 grams or whatever that capful is. I think it is 17 grams. Anyway, what a mistake that was!!! I cramped so bad I thought I would die. I kept taking it down and down and down until I was at 1/4 of a tsp. THEN it was okay. I stayed at that for about two weeks until I was sure I was fairly regulated. THEN I made the switch to Benefiber. But know also I have GERD, Gastritis and IBS. So, what I do HAS to treat both diahrea AND constipation. And I was taking the probiotic "Align". It works great too. I have just stopped it for a short while because I was trying to determine at that time if it was the Fibercon or the Align causing bloating and it was the Fibercon so I can go back to Align any time. However, I also know it causes bloating at FIRST then that goes away. It did for me as it was the first one I tried...before the Fibercon.

Ugh, I am rambling. But you are also right about walking...that will do it too! :) I know people have to try various things based on their conditions but the main thing with me is NO STRAINING WHATSOEVER...so anything stimulating can be bad for a number of reasons.

And last but not least, I could tell you all of a horror story....a barium enema impaction that sent me straight to the ER. And through no fault of my own; mainly due to a rectocele I have and another godawful story. To be honest, I wonder sometimes if THAT wasn't the cause of the fractured tailbone!!

OH my! Sallymander are YOU THERE????
 

I can't help but wonder if you've been well....sort of 'put off' by all of this discussion?

Curious? As for the prune/combo stuff...yes, like a 'jam' has been my impression of it and it's use....I've never ever gotten to THAT point yet...tho. Aside from my PN onset? When I wasn't 'puter versed...Well, I have to tell you then? I was ready to do either the mineral oil or cod liver oil dousing approach. I was sooo ignorant! [not to mention bloated, weak and sore from 'trying'!]

Kathi? All I can say is URRRPPP! Kind of like a dog or cat that's about to 'donate' something choice onto the carpet! At least, life isn't dull? As Mrs D has discussed about the needs to balance our Calcium/ViteD and Magnesium...That last one can be well, a surprising one. I let you all look up her prior posts about this delicate aspect. Unless of course, Mrs D wants to send you 'directly to go!'
OOPS! Did it again! Another bad pun! Sigh? Hugs and all to all - j

If gas is good........then I'm in the Olympics.:D
I've become the stereotype ole man, bald, paunchy,
overweight and............ Pull my finger......!
:eek::rolleyes:;):cool:

Thanks t o all who replied.
Bought a bag of prunes today, see what does.
Drinking hot water did nothing.
Since I fart like crazy guess I don't have a lot to worry about. :D:D

Hope this doesnt sound silly..
 

I'm not sure if this is bulk forming - but popcorn is not only very yummy but lots of fiber!!!!!!!!!!

The prune paste is a very good idea ,but Courious's
Dr. is wise lol fooled you..Been away and tired but what's
new..Even though they all the water drinking (univ said not good idea
not to drink 8 glasses of water) donlt think I agree,I think water
is a must,like the V,olive oil very good idea...Hugs to all Sue

Why K so very true/ Sue again.. :)

Miralax has always worked very well for me. I have had impaction type problems with fiber-type supplements, as Mrs. D suggested.

I agree I also take morphine and like Susan it's really helped,I mean the morphine and what Susan recommed.lol :confused: sorry been along
hard week,I just love those legs.I am at my friends house for 2 reasons
I need help and her grandchild it about to be born. Holding a new life
for me is better then anything or med to me.

Also having you door open well I just love the birds,the spring sounds,
I took a ride in my wheelchair in a different area without rain good day.
Now come sweet baby,the midwife is wonderfull with them,new life wow.
Hugs to all Sue

I Just wanted to give my little contribution to this discussion.

And, thankfully, it involves NO DRUGS, no prunes, no nothing. I happened upon it quite by accident and even though I have posted this elsewhere, since this is a thread on constipation, and stool softeners and the like, I just wanted to make sure all of you know about this alternative.

What is this miracle of science that works in 5 minutes and let's you have a bowel movement without straining????

The HOMEDICS SHIATSU MASSAGE THINGEEE that I have on my computer chair.

Here's how I found out about it

I was walking a few blocks from my home and they were selling a Constipation Chair for $269.00. There was this big chart on the wall saying all the benefits of sitting in the chair.

I gathered that the chair moved "down there", or rocked you or whatever it did. Somebody also called it a hula chair and she walked over to me and said 'this is the one from tv". Well, I have never seen one on tv but I said to myself $269.00 for a chair (it looked exactly like my computer chair by the way.

I just did a search for Hula Chair on youtube and you can see exactly how it works.

http://www.youtube.com/watch?v=ywJN2rcpEUw

So I went home and looked at the massage thing from Homedics that we had just bought from GNC for $89.99 and I said 'give this a try". It doesn't make your bottom go round and round like the Hula Chair does, but it does the trick, believe me.

I had already gone to the bathroom, BUT it was one of those days when you know you have more in you, but you don't want to spend another hour just sitting on the toilet bowl.

So I figured "kill two birds with one stone" Go on the computer and get your bowels up and running".

So I sat in the chair, turned on the power button, selected "lower back", and there is an option to keep it in one place (it normally goes up and down the back WHICH I DO NOT LIKE".

So there i was, the thing was doing its rolling thing on my lower spine. About 5 minutes passed and all of a sudden, I jumped up and I ran to the bathroom.

I could not believe it. No straining, no nothing.

I have been doing that ever since.

I usually go after morning coffee but sometimes you don't go ALL AT ONCE, and when that happens, I sit in the chair, switch it on, it does it thing, and I'm a happy camper.

I have no idea if this would work for all of you but believe me, if I had not seen that stupid constipation chair sign over the hula chair for $269.00 a few blocks from my house, i would have never known to sit in my own version of it.

Glory Be, the darn thing works.

So if you have tried everything, and you can afford it, (maybe you can test it out or something). My GNC has a model all rigged up and people sit down and love the way it goes up and down the spine.

I was in NYC the other day and there was a GNC next to Beth Israel Hospital.

I walked in and sure enough there was my Homedics thingee on some chair and I laughed and I went over to the guy behind the counter and said "you think this thing is only good for massaging the back??" and he said 'why, what else is it good for??"

Well, when I started to explain WHAT ELSE IT DOES, they were laughing all over the place and the girl said "wow, that makes sense, it stimulates the lower portion of the body". and I said 'EVERY TIME!!!

I'm telling you, if anybody has any of these massage things on any of your chairs, set it to stay on your lower back and see what happens.

Just wanted to share.

One word
 

SlowMag. I take SlowMag for the magnesium, obviously. One of the sides of SlowMag, any magnesium, is a laxative effect. If I'm having issues from taking the Tramadol I take a SlowMag tablet on an empty stomach before going to bed. It works like a charm for me. Otherwise take SlowMag with food.

Adding more fiber can certainly help. There's a drink out, can't remember the name of it, it's sugar-free and has 5 grams of fiber per pouch. You don't even know you're drinking any fiber. Can't taste it, can't feel it. Tastes good too! And it's not super expensive either. If I can remember the name of it I'll let you know.

There's also Colace, a stool softener that does nothing but soften the stools. There's no cramping or anything like that with it. It works real well too.

Jarett:

Is this what you are referring to??

http://www.ndlabs.com/product/635

This stuff has sorbitol. That will make anybody go!!!!

No...this stuff you can get at Walmart. It's called Vita Splash. They use Splenda to sweeten it. It's Raspberry Lemonade flavor.

Jarett:

Got it.
How fascinating. I've never heard of this. Thanks much.

http://www.fitsugar.com/249156

I am currently taking gabapentin, ultram, celexa, cyclobenzaprine, and a few other meds, and I had no idea that I would become irregular. Just as you stated, twice a day was normal 4 me, and I take my multi vit along with omega 3's daily. I have sinced greatly increased my dietary fiber (I thought just eating normal fruits and vegs would do the trick) I am still having issues, but if you decide to do the hot water, I suggest putting a large amount of pure lemon juice. It helps to get things moving. Taking so many meds have taken a toll on my life, and I hope that I do not have to turn to disability. I have herniated discs in my neck, per.neuropathy in both legs, and fibromyalgia. Getting enough fluids helps. I have given thought about getting an internal cleansing done, which I think may get me back to normal. Hope this helps! Good luck!

It's also a good bit cheaper than the price they quoted at that link. It's under 3.00 a box *if* I remember correctly, at WalMart.

Usually the more constipated you are the more hot water you will need, i wouldn't give up drinking the hot water after only a day or so, but it is your choice though.