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bww9 02-22-2018 10:23 AM

Is there any pain rx that doesn't cause constipation
The opiates all seem to cause this. Is there anything out there that works for pain but not cause constipation

tortoisegirl 02-22-2018 04:51 PM

Re: Is there any pain rx that doesn't cause constipation
Hi! Every opioid I can think of is known to potentially cause constipation. Some are known to be worse (morphine for example I think), some less (Fentanyl I think). However, some may be less or worse constipating for you individually, as everyone responds differently. It is also often dose dependent (worse with higher doses).

I think the easier route is to try to treat the constipation, and especially, proactively / preventatively. Nearly everyone on daily opioids needs something for constipation. The most commonly currently recommended first med seems to be Miralax. It is an otc powder you mix with any drink. I find something warm is better (like coffee), but with enough time, anything flavored will work. A full dose is one capfull once a day every day, but some folks are sensitive, so I'd recommend starting with 1/4 of one or so for a few days, then move up.

Others are on the opposite end, and take several capfulls each day. Some like stool softeners; however, those don't really help things move, and aren't currently as commonly recommended (vs. the Miralax, which draws more liquid into the bowel). Another thing to avoid is fiber supplements, as I have been told by my doctors that they aren't good for opioid induced constipation, and can actually make things worse.

It is very important to be taking something daily if it is a frequent issue, as once you know you have an issue with it, it is very difficult to get things moving again. I ended up on a combination of Miralax, Senna, and a rx called Linzess. However, I had constipation/IBS issues even before the opioids, and have other bowel issues now too. I'd recommend talking to your pain doc about this, as well as asking for a referral to a gastro doc if needed.
Best wishes.

Redhedd68 02-23-2018 01:12 AM

Re: Is there any pain rx that doesn't cause constipation
Hello, bbw

I can definately relate, as I've been on opioids for over 10 yrs, due to spinal issues. I have, also, had one major issue, extreme edema in feet & ankles, while taking almost every long-term pain med.
Back to dealing with the constipation you're experiencing; I would highly recommend Milk of Magnesia before bedtime. I originally tried Miralax (ughh). I find the taste and consistency nasty and it really did not work all that great for me.

My Dad recommends Milk of Magnesia over Miralax and other laxatives. In addition, he stated that increasing my fiber intake would help immensely.
I asked my pain mgmt dr if these two things were okay to replace the Miralax and he replied that if it worked for me, it would be fine, but differentiated that a fiber laxative should NOT be used in place of an actual fiber supplement (adding more to your diet helps, too).
Hope this helps, it definitely has kept things moving for me in the last 4-5 years.

Mybacksucks006 02-23-2018 04:14 PM

Re: Is there any pain rx that doesn't cause constipation
I myself have been on meds for years and years and I swear by taking magnesium daily. Talk to your doctor or pharmacist or do a little research of your own for the recommended dose, but it keeps everything moving and does it naturally which I love. Magnesium also does a little bit for pain and muscle spasms in my experience making it a win-win in my book. Stool softeners and laxatives, at least for me, can cause cramping and discomfort sometimes (especially at higher doses when you're really trying to get things moving again), where magnesium just works with my body. I take it before bed so that thru the night it pulls the moisture back into your bowels and keeps me regular daily! I hope it works for you too if you give it a try!!!

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