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View Full Version : Pain Meds & The Worst Side Affect


 

 

 
chriztene
01-05-2006, 08:19 AM
I would like to know how those of you who take extended release pain meds deal with the dreaded constipation issues they cause? I have tried laxatives, which worked in the beginning (lst couple years), however they no longer work. I am now needing to go to a prescription laxative and would like to know which method/Rx works best for you.

The two choices are Mirilax and Zelnorm? I thought oxycontin was bad, but, now that I have switched to Kadian, the constipation is even worse! I was truly hoping the Kadian would be easier on me since the delivery system is much smoother - not a chance.

Any advice/information woud be greatly appreciated,

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mpvt
01-05-2006, 08:39 AM
How active are you????If you can go for a walk after each meal this really does get things moving.Also try and drink alot of water.....Dave

ltedeschi
01-05-2006, 09:15 AM
I feel your pain. I went three weeks once where even the stuff that cleans you out for colonoscopy didn't work after laxatives, stool softeners, enemas didn't work the pm said just try Dulcolax I had been using fleet and boy did it work and I still have no trouble,
This is definately the worse side effect. I usually only go on Sunday when I can take a laxative the night before. This will ruin my colon but what is a person to do

tina76
01-05-2006, 11:13 AM
It is awful. I am on methadone and have had a heck of a time. My PM wants me to go EVERY day. Which seems impossible but I try my hardest. I drink a TON of water. Over 100oz a day. That seems to have helped things. I also take 500mg of magnesiusm each night. I use a laxative when thins get really backed up (milk of magnesia because it doesn't cause cramping) but often have to take two doses of it before it really starts working.

Fabrashamx
01-05-2006, 11:21 AM
I'm so glad someone brought this up, because it must be a problem for all of us! I notice when I dont walk I have a much harder time 'moving the mail' as it were. :rolleyes: , I use glycerine suppositorys once every 3-4 days, and between that and the walking I stay pretty regular. You can buy them over the counter, on the shelf by the tucks and stuff. I also try and avoid binding foods like cheese and lots of red meat. or at least balance it out with salads and fresh fruit. Hope you all have as pain free a day as possible!~Fabby :wave:

pedden
01-05-2006, 12:49 PM
My father got me taking Metumicil (sp?). This I take at night mixed with Tang, which makes it bearable. I use the regular flavor Metamucil mix it yourself stuff, not the pills. My father had experience with both and said the ony thing that worked was the mis it yourself stuff. Well I can report everynight I drink my Metamucil cocktail or whatever you wanna call it, and every morning I have a bowel movement, and I woudl say 98% of the time that is the only bwel movement of everyday, and also its smooth and very scheduled, being pretty much at the same time every morning. So I dont have to worry about leaving my house and having to use a public restroom, I just make sure all my appointments are sceduled after a certain time and go from there with a constipation free day, and thats amazing with all of the opiate treatments I am on, and the amount of constipation and bowel problems I had before my father turned me on to his drug of choice Metamucil. But as I always make aware in all my post, I am in no way a MD, so first I would speak with my MD or PM people about this regime beforehand to make sure it doesnt intereact with any of your meds at all, even the ones innocent might not be effective off of some of these home remedies. So just make sure you are aware that I recommend discussing everything with your healthcare provider first about everything, cause I dont wanna be the cause of someone elses problems because of my recommendation for something that works miracles in my life and with my very regular bowel movements now, which make my life managable now and also very pain free as far as constipation go.
Thank You for letting me share my input!!!!!
Sincerely,
Jonathan W. Motte :wave: :)

catnap
01-05-2006, 02:29 PM
I'm sure glad to see this brought up. I had it the other way, since gall bladder surgery in 83. Where things ran a bit too often and way too smooth!

Since changing from fentanyl and methadone to Avinza (like Kadian), I have noticed a big difference. I have used glycerin suppositories and stool softners and only getting some minimal relief.

Is there any problems with using the Dulcolax long term?

Thanks for the input.
Carol

pixiepoodle
01-05-2006, 03:07 PM
When my system gets backed up, I drink "Dieter's Green Tea", which has senna in it. You can usually find it in a grocery store and different stores carry different brands and flavors.

You have to be very careful and follow the instructions on the box because you don't want to start out keeping the tea bag in the water very long because its powerful stuff. Since I don't care for the taste of the senna in the tea, after I put the tea bag in the water and get the desired darkness (or should I say lightness), I then take it out and put a regular tea bag in (like Earl Grey) and then add my creamer and sweetner and it tastes like regular tea. It can take up to 12 hrs. to work and as long as you don't make it too strong, you should have a regular movement. Sometimes I do experience cramping if I've made it a little too strong, but its worth it to keep regular.

tina76
01-05-2006, 03:34 PM
I asked my PM doc if using a laxative was okay and she said it was when necessary. So I'm assuming she means after I use the other stuff (magnesium, water, increased fiber...) if I am still backed up to go ahead and use it. And I'm on the meds longterm so I'm assuming she would have told me if there were long term problems with laxatives. I know that if you take them TOO much your body becomes dependent on them and doesn't want to it's business on it's own. But I'm assuming if you are only using it once or twice a week ti should be okay. That is how often I use it and I told my doctor all about it and she said it was fine....

Shoreline
01-05-2006, 04:18 PM
I have a hopice recipe that I swear by, a also ocaisionally use OTC and prescription mds. It really takes a combination, rotaing them helps and you don't become solely dependnet on one product. Taking fiber withut somthing to increase the bowel contractions wjich slow or stop all tohgether with opiate use may just make you feel more bloated. You really need something that creates the contractions.

Magnesium is a very potent drug and usually reserved for prep prior to surgery, It's about the strongest ting you can use and it's my absolute last choice. The yakima paste works great, th active ingredient is Senna tea which is also the active ingredient in Sennekot.

I use it fairly regualrly but tdo mix it up if feeling blated, The best i ever felt was doing a 30 day colon flush as seen on TV. It really worked and for 50 bucks every two months may be wort it, but I still used other things in the arsenal with the flush, Like Yakima paste and Kritaloose, increase water. It really can be managed , it just takes more effort than any one wants to put into having a BM. LOL

Morphine was definitely the worst for constipation of all the meds I've used but I repond the best pain wise to morphine.
I'll get the recipe if anyone is interested.
Take care, Dave

lseidman
01-05-2006, 04:38 PM
I have taken Dulcolax, and when it says to take the recommended dosage, holy moley just do it. I didn't think it would work, so I took 3 and thought I was going away in a Ambulance.

Shoreline
01-05-2006, 04:56 PM
Here is the recipe for the fruit paste. I made my last batch in May and I'm just runnng out. So it was very cost effective over time. Just a lot of work and fruit. If you can't find bulk senna use senna tea bags and steep a bunch, whatever equals 4oz, I rwo entire boxes of tea bags and had do squeeze each bag to get the senna tea back, but it did work, I got about 1 cup and a half back from squeezing 60 bags. Ya really need a food processor to cut fruit before and mix after .unless you have some serious hand strength..

Yakima Fruit Paste
used in hospice care for terminal high dose patients

DOSE: 1-2 tablespoons per day

1 pound prunes
1 pound raisins-pitted
1 pound figs
4 oz senna tea (look in your health food store, it looks like a bunch of leaves)
1 cup brown sugar
1 cup lemon juice

1. Prepare tea-use about 2 1/2 cups boiled water added to tea and steep 5 minutes.
2. Strain tea to remove tea leaves and add only 1 pint tea to a large pot, then add fruit.
3. Boil fruit and tea for 5 minutes.
4. Remove from heat and add sugar & lemon juice. Allow to cool.
5. Use hand mixer or food processor to blend fruit mixture into smooth paste.
6. Place in plastic container and place in freezer. (Paste will not freeze but will keep forever in freezer).
7. Spoon out what you require each day.

Enjoy eating it straight off the spoon.
Spread it on toast or add hot water and make a drink.

* If the fruit paste is not working (you are not having bowel movements) then you need to increase the amount of fruit paste you are taking.

* If the fruit paste makes you have very loose stools then you need to cut down on the amount of fruit paste you are taking. Perhaps even taking it every other day in some cases.


Another recipe

POWER PUDDING:-
Ingredients:-
*3 1/4 cups cooked prunes
*2 cups apple juice
*2 cups prune juice
*1 cup bran
Puree the ingredients and refrigerate the mixture.
Start with a 2 or 3 ounce serving 3 to 7 days a week.Adjust the amount and frequency to achieve a normal stool pattern.
The large amont of sugar may cause difficulty for some diabetics.But for those who can handle the extra sugar,this can be good medicine.

dango
01-06-2006, 01:25 AM
Uh, yeah... Well I take Zelnorm, Asacol, AND Reglan... ...and I STILL get backed up. That should not even be humanly possible!!! :bouncing: Anyway, there are those 12 oz. bottles of cherry or lime flavored saline laxative in the drug store. It's carbonated and you pur it on ice and drink it really fast... ...at least that's what I did when I had my sigmoidoscopy and colonoscopy--and a few times since. Plan on spending the day at home! Don't eat anything after you take it (around 8pm or so).

mamakitkat
01-08-2006, 02:36 AM
I just had my third & fourth back surgeries on Nov. 11, had a terrible time with this. I found drinking 8 oz of orange juice and 8 oz of prune juice a day did the trick. I made sure I drank them by dinner time every day. Good Luck !!

chriztene
01-08-2006, 09:53 AM
Thank you for all of the other options! I initially did the ducolax, etc, and they eventually quit working. Then I did the prune juice with pulp (which is hard to find) and that eventually stopped working. Now, with morphine being the worst med thus far, I am going to try the fruit paste.

Thank you so much for the fruit paste recipe. I know in the beginning, I really didnt realize how serious being constantly backed up could be..AFter dealing with this issue for 3 years now, I am learning how important it is to keep yourself regular. Having chronic constipation can cause other serious health issues on top of what I am already dealing with.

I have found anything natural seems to work the best. I just tried the zelnorm for a week and it is definately not going to work! Although, Zelnorm is a good medicine for bloating and other symptoms assoicated with IBS.

Kadian is a fabulous pain med but it is terrible regarding constipation. Its as if the Kadian paralizes the motility of my colon all together! Has anyone had any luck with Mirilax?

Shoreline
01-08-2006, 11:28 AM
Good luck Christeen, You wil probably find that the dried fruit now comes on 12 oz bags instead of 16, Just through an extra bag of whatever one you like the most. I aded a bag of figs, but realized Figs have lots of seeds the processor won't get which could be a problem with folks that have stomach problems, particlarly dio-verticulitis. "Pits in the bowels" for seeds to fester in. So to be graphic, but it's something DV patients have to avoid. But the suggested stuff works, If you like apricots add an extra bag.

It is very thick when you cook it down. 10 miutes seems long and requires lots of stiriing. I guess IF had sqeezed a little more out of the bags I would have had more liquid to work with. But it's like bringing mincemeat to a good simmer.

It pretty much lasts forever with the amount of preservatives in the fruit and the lemon juice and the acidity of the fruit.

I still use Kristaloose a couple times a month and it was a god send but the paste is better.

There are 3 basics with coonstipation from opiates. The biggest is all opiates stop or limit normal bowel contractions. It's the effect it has on smooth muscle, just like urinary retention can become a problem. But constipation is bad and you do have to stay on top. The senna in the tea causes the bowels to move and contract along with the fruit "Fiber" realy works but something like kritaloose or a softner works by bringing extra water into the bowels.

Which is the second aproach to managing the problem. Certainly drink more and stool softeneers work by acting as a diuretic and bringing fluid to the bowels, Phos soda is the most potent OTC and extremely harsh on your body and shouldn't be used as a maint product. It pulls so much water from your system and you loose so much it can cause deydration, electrolyte imbalance, it's harsh on your system "BP and Kidneys" with repeated use and you may just be flushing water past a dry impaction that's not moving even with the gallon of water that comes out. It's really not a good alternative except for preps for procedures and in an emergency where the choice is the ER and being "Unimpacted manually" or surgery. :yikes: Slower hydration from milder meds like peri clocace or Pectin work better in the long run.


I've even met folks that drastically reduce their dose to cause the oposite effect of opiate constipation, but that can't be good for ya either. There has to be a better way than throwing yourself into mini wthdrawal. Whatever works and is safe for each person.

The 3rd is to increase fiber, we all know where to get fiber, but be sure to drink plenty of water as not to create a fiber blockage. I'm definitely speakin from experince, I've tried them all, researched them all and been to the point where I thought I would die like Elvis on the thrown, have a stroke or my back would just snap. 600 mgs of Kadian will certainly do it and so will the pump. So you have to become an expert on it.

The bowel cleanser was something I recently saw on TV, It actually did work and I used very little else that month. I started out using the max dose but after 2 weeks I was using the minimum. I was impresssed but it's a racket where they want you to sign up for 50 bucks auto billed and shiped every 60 days untill you tell them to stop. IT's like a record club but for constipated people. LMAO :bouncing: :bouncing:

Anyway, it's alot of work but it does work and last a long time for the initiuial 40 buck investment in dried fruit. Once you get working it's easier to maintain. I kept it in the freezer in those glad storage containers. It does have a tang but it's really not bad with a peanut butter cracker, use it as jelly or even by the spoonful. If that's doing the trick alone, I can kick start it with something OTC or prescribed "Kristaloose", the OTC stuff just seems so harsh in comparison.
Good luck, Dave

VA-GAL
01-10-2006, 11:12 AM
Right now I am so blocked up nothing is working. I have tried 2 enemas, senna laxatives, stool softners, suppositories - and still nothing is moving. I am starting to freak out a little that I am too blocked up that nothing is going to work. I have had small bowel movements every few days, but nothing substantial in weeks. Is this ok? When I say small, I mean very small amounts. I don't mean to be graphic here, but I am worried. This has me up at night worrying about it. I hate using stimulant laxatives as they cause horrible cramps. I do not have the time in the morning to have one of those hit first thing in the AM. I have 4 youngs kids I have to get off to school and a baby to watch. So I don't have time in the morning for stomach cramps and a big scene in the bathroom that stimulant laxatives cause me. I can only do that on weekends, lol. But right now I am worried about the fact that I have not had a substantial bowel movement since right after Christmas. Granted, I don't eat much, and I have been very ill with pneumonia for a week of that. I do not feel all bloated out or feel like I am all full if you know what I mean.

Sometimes, with all these stupid side effects, I wonder if this is all really worth it. If my pain wasn't so flipping bad I would throw all these stupid pills down the toilet.

So since the 2 enemas didn't work, am I in trouble? Do I need a professional to clean me out? Please help, I am freaking out.

VA-gal

tina76
01-10-2006, 02:26 PM
Shore - that's hilarious... A record club for constipated people! There's my laugh for the day! Thanks!!! :) :)

VA-GAL - Have you tried Milk of Magnesium? I have used all sorts that for some reason just don't work well for me... but that one always does. Sometiems I need to take two doses before it really hits but it always does eventually and then cleans me right out with NO cramping... just a suggestion if you haven't tried it yet...

VA-GAL
01-10-2006, 03:16 PM
Tina, Thanks for the suggestion. Yes that one usually works for me too. I have not been able to use it as I am on an anti-biotic right now for the pneumonia and I don't think I can mix the two. I will have to double check with the pharmacist on that one. I am desperate. The milk of magnesia usually works for me too for some reason. I hate it though as it upsets my stomach when I take it. Its always some price to pay, isn't it?

Va-gal

tina76
01-10-2006, 03:35 PM
I don't notice too much stomach upset with it? Probably because I am just so grateful to be going to the bathroom! Sad, but true! :) I like it because I don't get ANY cramping like I do with almost every other laxative there is... It's gentle...just like they say on teh commercials! It used to be I could take one dose and within a half an hour I'd be good to go... Now I normally have to take one dose, wait the day and then take another and by the next morning things are moving. I wish it was still as easy as it used to be! But it makes sense considering I was taking a lot less meds back then... the good old days.

I've never heard about not mixing the two? I'm fairly certain I have taken it while on anti-biotics? I wonder if I wasn't supposed to? Let me know what you find out since I've never heard that before.

rickyt
01-10-2006, 10:30 PM
I find raison brand work good for me..!!

dlp3300
02-06-2006, 09:05 PM
senna softgels, Dr reccomened.Can be found at any drug store.Take at night. I'm on Kadian .Works great!!! Drink lots of green tea,throw a couple flavored tea bags to add flavor.

mrsaa
02-07-2006, 05:46 PM
LOL!! THank you for bringing this up!! The constipation thing is a battle when one is on opiates. The severity of it has varied with the drug- ie) oxycontin(generic) made my stomach ache so badly, cramping, nausea, and if I was lucky, I would have 1 bm a week. I was using an enema, and Metamucil, as well as Colace, but nothing would make me feel any better. So I switched to a fentanyl patch, and I can stay regular if I eat high fiber foods (nuts, certain fruits, spinach, broccoli, other veggies, bran, oatmeal, beans) take a stool softener, and take a fiber suppliment if needed. That being said, it isn't the way it was before I ever started taking pain meds, but it is managable at least.

Alli





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