Suboxone And Constipation: A Serious Concern
Suboxone is a medication used to treat addiction to opiate and opioid drugs. For example, Suboxone can be used to effectively treat heroin addiction. Suboxone, along with drugs such as methadone and naltrexone, is prescribed by doctors as part of medication-assisted therapy for opioid addiction and dangerous opioid use.
Are There Medications That Can Help Is There A Good Suboxone Constipation Remedy
Many meds that help to resolve constipation are available over the counter in the pharmacy. There are products such as Colace, magnesium citrate or magnesium sulfate, Dulcolax , milk of magnesia, mineral oil, castor oil, Mylanta, Miralax or ClearLax , Gas-X , Senokot, BeneFiber or Metamucil, acidophilus, and probiotics.
Docusate sodium is the ingredient in Colace and other brands. Docusate is a stool softener. It should not be taken if you already use mineral oil. In addition to oral forms of docusate, it is also available as an enema.
Senna is a laxative derived from an herb. Both leaves and fruit from the herbal plant are used to make senna-based medications. Senokot is an example of a medication based on senna. Senna can be used in combination with psyllium or docusate sodium.
Magnesium, in addition to helping with constipation, also helps with muscle cramps. Magnesium is a supplement that may also be helpful to reduce the severity of some symptoms of opioid withdrawal.
Even though you do not need a prescription for these meds, it is still important to discuss them with your doctor before taking them. Your pharmacist can also be helpful in making decisions about OTC meds.
Even though these medications do not require a prescription, you might still want to ask your doctor for a prescription if you have health insurance. It is possible that having a prescription will get your insurance company to cover the cost.
Can The Health Food Store Help
In addition to carrying lots of healthy fruits, vegetables, and legumes, your local health food store may also carry a variety of natural remedies in the form of supplements. Often, the supplement department will have a consultant who can direct you to a variety of safe alternative treatments for various symptoms and ailments.
Of course, you should always inform your doctor if you are taking a natural supplement. Some of these natural treatments can interfere with medical treatments.
In addition to looking at natural remedies, fruits and vegetables, donât forget about other fiber-rich options, such as split-pea soup or lentil soup. There are many excellent foods that are full of healthy fiber and can help to improve your bowel movements.
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What About Seeing A Constipation Specialist
If nothing seems to be helping and you are in a situation where you do not want to make changes to your addiction medication treatment, consider seeing a specialist to further evaluate and treat your constipation. You can ask your family doctor for a referral to a gastroenterologist or. GI specialist.
This kind of doctor specializes in anything related to your digestive tract. This means that everything from where your food goes into where waste comes out is included in what they can handle.
In fact, if you are 50 years old, or if you are younger and have a family history of gastrointestinal problems, such as stomach or colon cancer, you should definitely see a GI doctor. Starting at 50 years old, it is recommended that all people get a colonoscopy.
A colonoscopy is a special test that uses a camera on a flexible tube to look through the entire large intestine. This means that the final stretch of the intestines is viewed thoroughly by the doctor. If there is an early precancerous growth, it can be removed during the colonoscopy.
Colonoscopies can prevent colon cancers and are highly recommended. Regarding constipation, the gastroenterologist is an expert in this area and can possibly put together a treatment plan beyond what your primary care doctor can provide.
Use Laxatives And Other Medications To Relieve Constipation
The American Gastroenterological Association recommends laxatives as the first line of defense for treating opioid-induced constipation. Laxatives facilitate regular bowel movements by increasing intestinal activity and/or softening the stool. Theyre generally considered safe and inexpensive and are often available over the counter .
When traditional laxative therapy isnt enough to produce acceptable symptom relief, the AGA recommends other prescription laxative medications, including:
- Intestinal secretagogues
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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.
Foods That Make Constipation Worse
According to Elisabetta Politi, MPH, RD, LDN, a dietitian clinician at the Duke University Diet & Fitness Center, foods with low fiber content can make constipation worse, which include:
Diets that are low in fiber don’t just cause or aggravate constipation, but can also result in appendicitis and hemorrhoids as well. It’s important to meet the daily recommended fiber intake to avoid the health risks that are associated with a low-fiber diet.
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Drug Treatment For Opioid
Prevention of opioid-induced constipation is always preferred over treatment. Exercise, added fiber in the diet with whole grains, fruits and leafy vegetables, and plenty of fluids can be helpful, but may not work for everyone. In these cases, typical first-line agents used in OIC include:
When To Seek Medical Treatment
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Drinking More Water May Help
Because one of the issues involved in constipation is water absorption in the colon, drinking more water often helps to reduce constipation problems.
How much water should you drink in a day? While it is not a good idea to overdo water intake, you may find that you are not actually drinking as much water as you should be drinking throughout the day.
The ideal amount of water that a person should drink daily will vary based on gender, age, and weight. Typically, it is around three liters daily. Keep in mind that the typical bottled water that many people drink comes in a 1/2 liter bottle.
You would need to drink around six of those bottles throughout the day. Of course, you may want to carry a refillable water bottle to protect the environment.
People who have kidney problems may have to modify their fluid intake. If you have any kidney problems, ask your healthcare provider how much water you should drink. It may also help to track your water intake. Consider using a dietary tracker that includes water tracking.
What Is The Difference Between Oic And Other Kinds Of Constipation
Some common forms of constipation may occur as a result of
- A lack of fiber in your diet
- Other medications
OIC is different. OIC, or opioid-induced constipation, is a term used to describe constipation that is the result of opioid therapy. Opioid constipation may last as long as you are on your opioid therapy.*
*Discontinue SYMPROIC® if treatment with opioid pain medication is discontinued.
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What Is Opioid Induced Constipation
Opioid-induced constipation, or OIC, is a condition that affects how your digestive system works. Opioids are strong pain medicines that slow bowel movements, causing fewer or more difficulty having a bowel movement than normal. Hence the term opioid-induced constipation.
Your healthcare provider might prescribe opioids if you have a condition that causes moderate to severe pain. Healthcare providers may prescribe opioids for pain from a procedure, such as surgery or dental work an injury or accident a chronic, or long-lasting, condition that causes pain cancer or illness at the end of life. While opioids can treat pain effectively, they have known side effects. Between 50 and 80 percent of people who take opioid medicines have constipation.
OIC is the most common side effect that opioids have on your digestive system however, there are others. Opioid-induced bowel dysfunction, or OIBD, is the medical term for the effects on the digestive system caused by opioids. Besides constipation, other symptoms of OIBD include heartburn, nausea, vomiting, bloating, as well as chronic, or long-lasting, abdominal pain.
This Post Has 3 Comments
When all else fails spend the 3$ & get a fleet enema. Not pleasant but it will work. Milk of magnesia, try that first definitely.
Been on suboxone since 2007. Every summer i get wickedly plugged up without fail.
Idk why this is other than perhaps all the snow shoveling i do in the winter gets things moving. ð
Iâm taking buprenorphine w/naloxone to cure an addiction I had with oxycodone. Iâve been taking this since Dec. 2019 and now am suffering from constipation. Am taking three times a day and thinking of cutting down gradually.
One thing not covered in this article is the spit vs swallow issue. Many people are not sure what to do when the sublingual buprenorphine tablet or film is fully dissolved. Is it correct to swallow the remaining mouthful of saliva or spit it out? The medication manufacturers do not cover this in their instructions. Many patients believe that swallowing the saliva will improve the effectiveness of the medication. This is not true. Buprenorphine is not active when swallowed, other than it may possibly interact with opioid receptors in the intestines. When an opioid stimulates opioid receptors in the intestines, it can lead to lower motility and constipation. I donât know if any studies have been done on this, but some patients report less gastrointestinal upset and constipation if they spit out the saliva after the medication has been dissolved under the tongue.
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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.
More Options For Opioid
Osmotic cathartics such as lactulose or polyethylene glycol increase water in the bowel and help to move the bowel movement more quickly through the intestine.
- Polyethylene glycol is not absorbed into the bloodstream and can be used longer-term, if needed. It can be given daily as a preventive for opioid-induced constipation – , or can be used intermittently .
- Lactulose can be given in a daily dose of 30 mL as a preventive for OIC. It can lead to excessive gas, cramping and bloating, and may need to be avoided in patients who are lactose-intolerant and those who require a low galactose diet.
Bisacodyl is a stimulant laxative that is also available without a prescription.
- It can be used intermittently orally or as a rectal suppository for constipation, but can cause some cramping and explosive diarrhea.
- Bisacodyl suppositories usually produce a bowel movement within 1/2 to 1 hour, while tablets usually take 6 to 12 hours.
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What Are Normal Bowel Movements
Normal bowel movements are different for everyone. If you usually have two or three bowel movements a day, three in a week means you are constipated. For some people, though, three bowel movements a week is normal.
“Normal” stools are soft, formed, and are not painful. Normal bowel movements can also be controlled.
There is no rule for how often you should have a bowel movement. Constipation is when your bowel movements are less frequent than what is normal for you.
The longer you go between bowel movements, the harder your stools will be. This is because the stool dries out in the colon as water is absorbed back into the bloodstream.
Methylnaltrexone Is A Quaternary Amine Derivative Of Naltrexone
Opioid analgesia is the result of agonist actions on opioid receptors in the CNS.2,3 However, constipation is primarily the result of opioid actions on receptors in the bowel.3
Naltrexone is an opioid antagonist that can cross the blood brain barrier. It may reverse opioid-induced constipation but will also reverse the analgesic effect of opioids in the CNS.2,4,5
Methylnaltrexone is produced by adding a methyl group to naltrexone.5 This increases the polarity and lowers the lipid solubility of the molecule, preventing it from crossing the blood brain barrier when it is given in clinically appropriate doses.4,5 As a result, methylnaltrexone does not reverse opioid analgesia.
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Home Remedies For Opioid
A few home remedies may also improve OIC or help you manage discomfort. Try these along with medications or natural remedies:
1. Increase physical activity. Exercise and physical activity stimulate contractions in the intestinal tract and promote bowel activity. Aim for 30 minutes of exercise most days of the week. Talk with your doctor before starting a new exercise routine.
2. Drink plenty of fluid. Dehydration makes it difficult to have a bowel movement. Drink 8-10 glasses of fluid per day. Stick to:
3. Eat more fiber. Increase fiber intake naturally to normalize bowel activity. Add fruits, vegetables, and whole grains to your diet. Excellent sources of fiber include:
Side Effects And Impact On Quality Of Life
Three-quarters of patients currently taking opioids reported side effects with their use . The most common side effects were gas, bloating or fullness, and sudden urge to defecate . Side effects were more common in younger patients: 83% of patients younger than age 40 years reported at least one side effect, compared with 73% older than age 40 years. The most common side effects in younger patients were gas, sudden urge to defecate, and false alarm . There appeared to be no association between side effects and opioid strength or occupational status .
Laxatives were considered to interfere at least a little of the time with work for 58 of the 122 patients currently taking them and with social activities for 62 . Sixteen patients reported that laxatives substantially interfered with social activities this was most commonly attributed to gas, bloating, urge/fecal incontinence, and false alarm.
Almost half of the patients reported that they had used other interventions to help with their constipation since starting their current laxative. These included herbal remedies, massage, and use of enemas. Forty-two patients said that they removed hard or dry stools by hand. Almost half of patients who had experienced frequent constipation before starting opioids, 20 of 43 , used manual evacuation methods , compared with 42 of 142 who were not previously constipated.
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