Treatments for Opioid Constipation

When you’re taking opioid medications to relieve pain, you might feel one of these drugs’ most common side effects: constipation. It can be a serious problem -- but you don’t have to just grin and bear it. Treatments can give you relief and make it easier to keep taking your pain medicine.

Changes to your diet and other habits may help, but some people on opioids will also need to take medications to keep their bowel movements regular.

Laxatives and Stool Softeners

These are the first things most doctors recommend, and they're the same meds that anyone with constipation might use. Your doctor may suggest you take one before you even have the problem to prevent it.

Stool softeners make hard, dry waste easier to pass out of your body. Laxatives help your bowels move the stools out. You can buy many of these treatments over the counter. Ask your doctor or a pharmacist which ones may be best for you, and how long you’ll need to take them.

They'll start working after a few hours or a couple of days, depending on which laxative or stool softener you use.

Drugs for Opioid Constipation

When laxatives and stool softeners aren't enough, your doctor may prescribe a medication that’s made for people who have constipation because of opioids. These meds work by blocking the effects that the drugs have on your gut:

Try a Different Opioid

All opioids can cause constipation, but some may have less of an effect than others. Some studies have found that fentanyl may cause less constipation than morphine. Tapentadol may also be easier on your intestines than oxycodone. Methadone may also be less constipating.

Talk to your doctor about which drugs will give you the right balance of pain relief and fewer side effects.

Other Treatments

You can try options other than medicines to relieve constipation, too.

Rectal suppositories are laxatives that you put inside your bottom, where they dissolve and your body absorbs their medicine. An enema is a liquid that you flush into your bottom to clean out your colon.

These treatments can help, but doctors don’t often recommend them since they’re uncomfortable. As a last resort, your doctor or nurse may use a gloved finger to get stool out.

The most important thing you can do is to talk with your doctor about your constipation and how you can feel better.

WebMD Medical Reference Reviewed by Melinda Ratini, DO, MS on November 01, 2017

Sources

SOURCES:

Uptodate.com: "Cancer pain management with opioids: Prevention and management of side effects."

Dorn, Spencer et al. The American Journal of Gastroenterology Supplement, 2014.

Supplement to The Journal of Family Practice, December 2015.

University of Wisconsin Health Pain Care Services: "Management of Opioid Induced Constipation."

Palliative Care Network of Wisconsin: "Opioid Induced Constipation Part II: Newer Therapies."

American Chronic Pain Association: "Opioid Induced Constipation."

Medscape. “FDA Okays Naldemedine (Symproic) for Opioid Constipation.”
 

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