Opioid Constipation: 5 Ways To Get Relief
Constipation, or trouble pooping, is the most common side effect of the pain meds called opioids. Most people who take them will need to also take specific medications to get more regular bowel movements.
But some simple habits you can start at home can make a difference, too. Try these tips to get relief.
Drink more water.Dehydration is one reason many people get constipated, and opioids can make it worse. Plus, it can be tough to get the amount of fluids your body needs when youâre in pain.
Try to drink more H2O throughout the day, even if you sip a little at a time. Hot liquids, like coffee, tea, or broth, can get things moving, too. You can also suck on ice chips, or nosh on foods with a lot of water, like watermelon or berries.
Eat more fiber. It can help keep your bowels regular. One kind of fiber, the “soluble” type, is especially helpful for opioid constipation. You can get it in foods that get soft when you add water to them, like oatmeal, barley, and flax. You can also get fiber from fruits , vegetables, whole grains, seeds, and nuts.
Don’t use fiber products that have psyllium. They can make opioid constipation worse.
Stick to a routine. Try to go to the bathroom at the same time every day. For many people itâs in the morning after breakfast. And make sure you have a place to go that feels private.
If you feel like going, don’t wait. That can make constipation worse.
Administering Hydrocodone To Dogs
Hydrocodone is generally provided 2 to 4 times a day, as required. Its impact can last from 6 to 12 hours.
If your dog is undergoing hydrocodone treatment, you need to keep an eye on him for strange side effects.
Even if the dogs state is enhancing visibly, you should not stop treatment earlier than recommended, as the dog can establish resistance and there likewise may be a regression. If the dogs health is not improved, you must consult your veterinarian prior to providing supplementary doses.
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Deterrence And Patient Education
Whenever an opiate is prescribed, the patient should be educated on the prevention of constipation. This means eating an adequate fiber in the diet, drinking ample water, exercising to encourage motility of the bowels, limiting intake of other painkillers, and using a laxative. Other alternatives instead of milk of magnesia include the use of docusate or polyethylene glycol. The changes in lifestyle should start at the same time as the opioid therapy and continue for the duration of treatment.
There are many fiber-rich foods that one can eat to treat constipation. Fruits like apples, bananas, prunes, pears, raspberries, and vegetables like string beans, broccoli, spinach, kale, squash, lentils, peas, and beans are often recommended. One can also eat almost any type of bran products and nuts. When eating foods with fiber, it is important not to consume more than 25 to 30 grams per day otherwise it can lead to a bloating sensation.
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Managing Constipation After Surgery
Unfortunately, constipation is a common side effect of surgery. It can happen for a few different reasons: the anesthesia used during the procedure, pain medications youre taking or how much and what youre eating and drinking.
Opioid medications are often used to manage pain after surgery, but they commonly cause constipation. Studies show that 40 95% of patients taking these medications will experience this side effect. To minimize it, anesthesiologists at HSS carefully construct a pain medication plan using different types of drugs, including acetaminophen , nonsteroidal anti-inflammatories , opioids, anesthetic medications and medications for nerve pain. This is done to maximize pain relief and minimize the use of opioids, as well as their side effects.
Steps to Take Before Surgery
If you have concerns before your surgery about constipation, the best thing to do is to ask your surgeon or care team about it. Some things to try:
Steps to Take After Surgery
At HSS, we conduct a thorough medication education session when preparing to send patients home. A nurse goes over all prescriptions, explaining how to take each medication to effectively manage constipation at home. Wherever you have your surgery, be sure you know how to properly take your medications to avoid this side effect before you go home.
At home, there are a couple of general rules to follow to help prevent or manage constipation:
Medications That Cause Constipation
You have heartburn and an acid taste in your mouth. You know that you are having acid reflux. You bought an antacid liquid and started using it. After a few days, you got constipation. Wonder why?
The reason is, some medications can cause constipation. It is a common side effect of many over the counter as well as prescription medications. Here is a list of medications that can make you constipated.
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Why Do Opioids Cause Constipation
Opioids have several different effects that slow down digestion. In the stomach, opioids can cause gastroparesis, which means that the stomach takes longer to empty than it should because the muscles are not working effectively.
Food moves through the small intestine because of muscle contractions known as peristalsis. Opioids affect the middle of the small intestine by increasing circular muscle contractions, which are non-propulsive contractions, and this decreases the peristalsis that normally moves food along. This can also create harder stools, making them more difficult to pass.
Opioids also affect how the anal sphincter responds to the drug. When stool is in the rectum, there is a natural urge to go to the bathroom and pass it. Opioids can dampen this sensation so that when there is a stool to be passed, a person doesnt feel it. That could lead to holding stools in too long.
Overall, these effects on the digestive system mean that some people will experience constipation when using opioids. For people who need long-term pain management with these medications, this can be a significant problem.
Treatment For Hydrocodone Addiction
A person struggling with hydrocodone addiction does not have to be alone. There are many inpatient treatment programs for opioid use disorder that immerse the individual in a community of love and support. Getting away from everyday life is often the first step toward recovery.
Treatment programs in inpatient drug rehab centers may be tailored to the individual. Many take a holistic approach, aiming to heal a persons mind, body and spirit. The best programs go beyond treating the addiction and also address underlying issues that may contribute to substance misuse.
Some treatment plans include medication-assisted treatment for opioid addiction, which combines medication with various treatment methods such as behavioral therapy, counseling, and support groups. Other important aspects of treatment may be learning life skills, exercising coping techniques and rebuilding family relationships.
To learn more about the dangers of snorting hydrocodone and to explore treatment options, contact us today.
This page does not provide medical advice.
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Opioids And Constipation: It Happens
You probably already know that opioid use is accompanied by many side effects like sedation, nausea, and tolerance. An opioid is sometimes called a narcotic, and they are used for varying degrees of pain.
But what you may not know is that one of the most common and troubling side effects with opioids is opioid-induced constipation. In fact, 40% to 80% of patients taking opioids over the long-term may suffer from this side effect.
Talking about constipation can be embarrassing, but it can be a serious side effect and deserves your attention. Opioid-induced constipation can occur among patients with chronic non-cancer pain, such as:
- musculoskeletal pain like severe back pain
- osteoarthritic knee pain
- other degenerative joint pain
Although guidelines states opioids should not be used first-line as treatment for chronic pain, they may still be prescribed in certain acute circumstances when benefit outweights risk. In addition, opioid-induced constipation can happen quickly — in a matter of days — and can result in more serious complications, like fecal impaction, anal fissures, rectal bleeding or prolapse, stomach pain, hemorrhoids, or perforation. It’s nothing to laugh about, and it is important you bring up constipatin concerns with your doctor.
The Dangers Of Hydrocodone Abuse
When someone takes hydrocodone for an extended period of time, they will likely develop a tolerance to it. The body adapts to the substance and requires the person to take a higher dose for the same effect. This can lead to physical dependence, a state in which someone must take hydrocodone in order for their body to operate normally.
Physical dependence is often accompanied by addiction, a mental craving for the drug that results in drug-seeking behaviors and compulsive use despite negative physical and social consequences.
Often, someone who becomes addicted to hydrocodone begins taking it as prescribed by their doctor. Over time, they take more and continue to take it longer than recommended. Because snorting hydrocodone takes it to the brain more quickly, they may begin to abuse it in this way, especially if they have built a tolerance to it.
Many states monitor controlled substances, making it more difficult for people to go doctor shopping and obtain multiple prescriptions. This may prevent some people from abusing prescription opioids, but those suffering from addiction may obtain hydrocodone on the street.
Sadly, some people who begin abusing prescription opioids eventually turn to heroin. Also an opioid, heroin has many of the same effects as hydrocodone, but it comes at a lower cost. It may also be more dangerous, as it is frequently laced with impurities and other substances like fentanyl, which can be deadly even in small doses.
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How To Treat Opioid
Opioid-induced constipation results in bowel movements that are infrequent or incomplete due to a side effect of opioid medications.
Prevention of OIC is always preferred over waiting to treat it due to the possibility of complications from unaddressed constipation. For example, changing diet, increasing fluids, adding dietary fiber, stool softeners, or other laxatives — along with opioids — to help prevent constipation from opioids is a common and accepted practice.
This may be especially important in the elderly, those with limited mobility, or those who take other drugs that also cause constipation .
However, when OIC does occur, the basic principals of treating opioid-induced constipation are similar to the methods used to handle most other opioid side effects:
- lower the opioid dose, which may not always be possible dependent upon pain levels
- manage the side effect with other medications or lifestyle changes
- change the opioid to a different class of pain medication that is less constipating.
Why Do People Snort Hydrocodone
When taken orally, hydrocodone travels through the body before entering the bloodstream and affecting the brain. When someone snorts hydrocodone, blood vessels in their nose absorb it, producing a quicker and more intense high.
Though smoking and intravenous injection both take a substance to the brain faster than insufflation, these are not common methods of taking hydrocodone and have a reputation of being more dangerous. Snorting a drug is no safer than smoking or injection, but many people believe that it is.
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Can Oxycodone Cause Constipation
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Aga Guidelines On Treatment Of Opioid
In the 2019 American Gastroenterological Association guidelines for opioid-induced constipation, laxative use is strongly recommended as a first-line agent.
- For patients with opioid-induced constipation who do not respond to laxatives, naldemidine and naloxegol have a strong recommendation for use, with methylnaltrexone having a conditional recommendation. All of these agents are recommended over no treatment.
- The intestinal secretagogue Amitiza was FDA-approved for OIC in 2013, but AGA makes no recommendations in the guideline due to an evidence gap.
- No recommendations are made for use of the selective 5-HT agonist prucalopride because the available evidence is insufficient to determine a true effect. Motegrity is not currently FDA approved for OIC, even though some clinicians may consider its use off-label.
The Dangers Of Snorting Hydrocodone
Snorting hydrocodone can damage the nose, throat and lungs. Misusing this prescription drug may lead to addiction and further adverse health effects.
Hydrocodone has a high potential for abuse and is often used outside of prescription guidelines. Some people misuse this drug by crushing and snorting it, which can be very dangerous to the body and mind.
The nose is filled with tiny blood vessels that are sensitive to foreign substances. When hydrocodone is inhaled through the nose, it inflames the nasal tissue. Cells inside the nose may become infected and die, causing nosebleeds and possibly ruining a persons ability to smell.
With prolonged misuse, hydrocodone can eat away at the nasal tissue, which may leave a hole in the roof of the mouth or the wall between nostrils . This can make it difficult for someone to eat, drink or even breath normally.
Since the nose is connected to the throat, it is possible that the snorted hydrocodone will drip onto the vocal cords, causing a sore throat and hoarse voice. Some of the drug may get into the lungs as well. Snorting opioids has been linked to irritated lungs and worsened asthma.
Coping With Constipation Caused By Opioid Medication
Patients experiencing chronic pain caused by arthritis often take one or more medications for pain relief.
Unfortunately, constipation is a common side effect of many pain-relief medications especially opioid pain medications . Commonly prescribed opioid pain medications can cause constipation because they slow down bowel motility.
While prescription pain medications, or analgesics, are commonly referred to as painkillers or narcotics, the preferred medical term is opioid pain medications, or opioids, which are the terms used in this article.
Chronic pain is also closely linked to depression, so some patients may be taking an antidepressant medication in addition to an opioid pain reliever. Some antidepressants, such as amitriptyline , sertraline , and imipramine , can also cause constipation. Obviously, patients taking both opioids and antidepressants are at an increased risk for developing constipation.
However, there are effective remedies to address constipation caused by pain medication, including a wide range of self-care techniques. Fortunately, many of the self-care techniques to reduce constipation are helpful in alleviating arthritis symptoms, and are generally healthy lifestyle choices.
For severe constipation, there are also a number of medications and other medical treatments available.
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Additional Options: Opioid Antagonists And A New Laxative
Opioid antagonists work peripherally binding to the opioid receptor and prevent the constipating effect from narcotics.
Unlike laxatives, peripherally acting Î¼-opioid receptor antagonists directly affect how opioids cause constipation however, the pain-relieving effect of the opioid is not blocked.
FDA-approved PAMORA regimens include:
Lubiprostone is also used for opioid-induced constipation , but is not an opioid antagonist. Pharmacologically it is a type-2 chloride channel activator and is classified as an osmotic laxative.
- Amitiza is FDA-approved for treatment of OIC in adults with chronic noncancer pain, including patients with chronic pain related to prior cancer or its treatment who do not require frequent opioid dosage escalation. Can lead to nausea and stomach pain side effects.
- It is also approved for irritable bowel syndrome with constipation and idiopathic chronic constipation.
Enhancing Healthcare Team Outcomes
Ways to prevent opioid-induced constipation is by working as an interprofessional team consisting of a nurse, pharmacist, gastroenterologist, and a pain consultant. It is important to manage pain with non-opioid drugs, and the patient must be educated about the adverse effects by the pharmacist and clinician including constipation. The nurse should encourage a diet high in fiber, ample water, and regular exercise. The pharmacist should recommend discontinuation of drugs which cause constipation and suggest other options. If opioids cannot be avoided, a laxative and high fiber diet should be started simultaneously, and the nurse should monitor the patient’s bowel habits. The patient’s pain should be periodically assessed, and the dose of narcotics decreased gradually. An interprofessional approach to patient education may help prevent this problem and improve outcomes.
Unfortunately once OIC has developed, returning bowel function to the pre-opiate status is difficult. Even though many novel drug combinations have been developed, no long-term studies are available to determine their effectiveness. Almost all studies suggest that use of non-opiates should be the drugs of first choice to manage pain if one wants to avoid OIC.
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Oic Vs Functional Constipation
Constipation occurs when stools are infrequent, hard, and difficult to pass. However, its not an exact science because a person’s stools and how often they pass them is individualized.
In general, having healthy bowel movements could mean going anywhere from three times a day to three times a week. However, a change in bowel movements may indicate constipation. If its suddenly more difficult to go to the bathroomthis could mean straining on the toilet bowl or bowel movements that are a lot less frequentconstipation may be occurring.
Symptoms of constipation can include:
- Feeling like a bowel movement is not finished
- Straining on the toilet bowl
Opioid-induced constipation is different than constipation that is functional. Functional constipation could be from a variety of causes ranging from not enough fiber in the diet to a disease or condition in the digestive tract. Opioid-induced constipation, however, is a direct result of the way that opioid medications affect the small intestine and the colon, by slowing down digestion.