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Old 09-02-2009, 07:48 PM   #1
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Pain meds and chronic constipation

I've been in Pain Management for approximately 4 years now. I have PLIF L4-S1, sciatic nerve pain, numbness in right leg from knee through entire right foot and SI joint separation. My meds were changed from hydrocodone 5/500 5 times a day to Morphine Sulphate ER 30 MG 2 times a day 2 years ago and 1 year ago added in oxycodone 10/650 1 1/2 tablets per day and 4 months ago Soma 250mg 1 time at night. In the last year I have become increasingly constipated. I know it goes hand in hand but I have tried many OTC products. Miralax worked the best but now my doc has me taking it daily and still nothing most days. I will go 8 days or more and not even an urge. I recently had my gallbladder removed 2 1/2 weeks ago and thought it would change. I am constantly bloated which is miserable in itself. I am not a big eater so I am sure that is part of it, yet I still weigh more than I should for my height etc at 150. I am not one to eat a bunch of fruits and veggies every day to bulk things up, I simply cannot eat much because I get full so fast. I can eat A piece of fruit per day and veggies with dinner but that's it. Usually a cereal bar for breakfast to take bp meds and maybe crackers during the afternoon if I need a quick fix. Occassionally lunch but then I am too full for dinner. I drink tons of water daily and 2 cans of diet coke. That's pretty much it. I know many of you have gone through this. Please tell me what you find to work for you. It doesn't bother me in the way of pain or anything, just that I know it is not normal and the awful bloat. Please help me. I did look through the bowel disorder board but that isn't the same as pain med related.

Sincerely,
Frosty

 
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Old 09-03-2009, 07:07 AM   #2
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Re: Pain meds and chronic constipation

Hello Frosty. Here are two very recent threads on the issue....Lots of great information in them by a variety of people.

As you will see in the threads, I'm a big fan of Metamuical...It's pure husk fiber, and very natural.

Any questions, please let me know.

Regards,

Ex

http://www.healthboards.com/boards/showthread.php?t=702926


http://www.healthboards.com/boards/showthread.php?t=706102

 
Old 09-03-2009, 08:40 PM   #3
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Re: Pain meds and chronic constipation

Hi Frosty,

The constipation from pain meds is an unfortunate side effect and it can make your life a misery.

I take metamucil and it's the best thing in the world - I only wish I'd found it sooner. Ex helped me to work out how to take it, and enough of it. The best starting dose is 2 tablespoons after dinner with lots of water. I'm not a big eater either so I take 3 tablespoons, 1 in the morning and 2 at night. I really hope you give it a go - within 3 days everything should have changed.

Good luck

 
Old 09-04-2009, 11:12 AM   #4
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Re: Pain meds and chronic constipation

Ex,
thank you for the links, as always very informative...
I want to know if Metamucil gives you a lot of bloating and stomach pains, gas (sorry), especially the one which is sweet. I am taking Metamucil every day as well as Mirolax twice a day, then Phyllis softeners and still have problems.

 
Old 09-04-2009, 12:59 PM   #5
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Re: Pain meds and chronic constipation

Saw this thread thought I'd jump in. This is a big problem for me too. I used to be very regular. Now, if I don't take ducalax, I don't go. I know that this is not a great thing to take on a regular basis, but metamucil doesn't work for me. I've tried cereal, nuts, etc. At some point it becomes painful. I'm wondering what I can do that's safe (long term) and will allow me some regularity.

 
Old 09-04-2009, 03:05 PM   #6
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Re: Pain meds and chronic constipation

Dmarcus,
you are right about stimulants - they are not good in a long term to take.
Try Miralax, not cheap, but very mild laxative. First try to take one cup just once a day, if not working - take one AM and one PM. With plenty of fluids.

Than I use Phillips: caplets of a very mild laxative ( I take 2 after breakfast and 2 at night) and also same brand stool softeners (they are great, no crumps, no stimulation).
I keep changing them, since body tolerance and some of them stop working.
The one you take is too harsh and can be taken only for a short period of time since like every stimulant causing colon inflammation.

If Metamucil is not working for you, try what I use: PSYLLIUM (seed) WHOLE HUSKS (BY YERBA PRIMA). 100% natural colon cleanser fiber supplement. No sugar or sugar supplement added, high in fiber. Gluten free.

Start slow and add every week a little bit more as every fiber supplement to avoid painful bloating.

Best wishes,
Moldova

Last edited by Moldova; 09-04-2009 at 03:05 PM.

 
Old 09-04-2009, 03:12 PM   #7
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Re: Pain meds and chronic constipation

You guys are so wonderful. Always a wealth of knowledge! We've been together for years now it seems. I honestly appreciate your advice on this sensitive subject and hope it will help others too. I will let you know what I find that works the best for me too out of your recommendations!

Love to all,
Lisa

 
Old 09-04-2009, 03:40 PM   #8
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Re: Pain meds and chronic constipation

I am going to buy the Metamucil tomorrow. Thanks for the advice.

I am terribly constipated at the moment.

I have IBS, so I have to be very careful of what I take. I cannot take Mirlax. Although it works, I get VERY bloated and get horrific gas (so smelly that even my kids don't want to be around me...ha).

Best of luck to you.

jdsun

 
Old 09-04-2009, 07:52 PM   #9
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Re: Pain meds and chronic constipation

Quote:
Originally Posted by Moldova View Post
Ex,
thank you for the links, as always very informative...
I want to know if Metamucil gives you a lot of bloating and stomach pains, gas (sorry), especially the one which is sweet. I am taking Metamucil every day as well as Mirolax twice a day, then Phyllis softeners and still have problems.
At first, you may be experience a little gas and bloating...Until your body adjusts. Also, small adjustments can make a big difference. For example, I recommend starting with 2 heaping tablespoons after dinner. If it's not working that great after a couple of days, go to 2.25 heaping tablespoons, then 2.5. it takes about 4-5 days to fully kick in.

On the other hand, if you get bloating and gas, then back off by about a quarter tablespoon.

Good luck,

Ex

 
Old 09-05-2009, 03:06 AM   #10
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Re: Pain meds and chronic constipation

I think a lot of people fail with metamucil because they don't realise that we (CP) patients need to take a lot more than the recommended doses - Ex's advice is great....I've been recommending it to friends and my dr is doing the same with only one lady that couldn't tolerate it but she had a gastric bypass, I think. It's all about taking enough to work.

 
Old 09-05-2009, 08:26 AM   #11
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Re: Pain meds and chronic constipation

Thanks, I'll give it a try!

 
Old 09-05-2009, 06:20 PM   #12
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Re: Pain meds and chronic constipation

Quote:
Originally Posted by Jema X View Post

I think a lot of people fail with metamucil because they don't realise that we (CP) patients need to take a lot more than the recommended doses
Jema is right. Either people don't give it enough time for it to work right, or they don't take enough. Many will start the supplement and if they get a bit of gas or bloating, they stop. It takes about 5 days or so for it to get your system "regular." In addition, your body will get adjusted to the med and the gas and/or bloating will cease.

Also, small adjustments can make a big difference. For example, 2 tablespoons may not work, but 2 and a quarter tbsps will. People have to be patient and stick with the program. It will work.

Regards,

Ex

 
Old 09-06-2009, 12:19 AM   #13
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Re: Pain meds and chronic constipation

DMarcus, I'm glad you're going to give it another try (I believe you tried without success in the past?). It really is trial and error but most people find that by following Ex's guidelines (and starting with 2 tablespoons), it only takes a few days before you're more regular. Then, if you're stools are coming out too easily or floating, you know you can back off a bit - or if you're like me and still having a bit of trouble, you can add in an extra tablespoon or so until things are perfect.

Gas is the worst side effect but in all honesty, if you take the metamucil after dinner, you're only going to experience it over night (and I've not heard of it being painful - most seem to actually find it a relief because it signals that things have already started moving, a hospital nurse explained this to me - gas is the first sign of movement). Compared to many of the side effects that we experience with our meds, this one is pretty easy to overlook and goes away quickly. I take one tablespoon at breakfast (as well as 2 after dinner) and never experience gas anymore. If I get gas, it's usually caused by stress and a peppermint tea will soon relieve it. Actually, if I remember correctly when I started metamucil I followed the night dose up with a peppermint tea (because you need to make sure you get enough fluid and because it helps relieve gas). I too have a sensitive stomach and have no problems now. I don't actually use 'metamucil' now but a blend that provides the same benefits and fibre amounts. I still think that metamucil is the gold standard for those starting out.

Ex and I, in our experience of pushing for natural relief (rather than miralax or stimulants etc) have both discussed that so long as you get the doses right, it seems to work for everyone. I strongly urge you to give it a try and not give up. I have suffered chronic constipation and frequent compactions (even before meds) for years and all of those problems are now a distant memory.

Hmmm...I think I've said enough

 
Old 09-06-2009, 08:14 AM   #14
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Re: Pain meds and chronic constipation

Quote:
Originally Posted by Jema X View Post

so long as you get the doses right, it seems to work for everyone.
At the risk of sounding too repetitive, I cannot stress this enough.


Quote:
Originally Posted by Jema X View Post

Hmmm...I think I've said enough
Me too!


Regards,

Ex

 
Old 09-06-2009, 11:08 AM   #15
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Re: Pain meds and chronic constipation

My Mother's DR. recommended that she buy the diabetic LifeSavers...they have sorbitol in them....and if you eat several of them....supposedly all of life's problems will be solved....they were for her...and she is a chronic lax. user....I know that this is not a replacement for all of the fiber we eat/and fiber we can consume in various other ways....but if your are having a problem....this one seemed to help Mom overnight.. The sorbitol is the thing...too much of it and wow....so I guess that can be a good thing once in a while.
Hope you are feeling better Frosty....

Leslie

 
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