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Thread: Constipation Relief when using Narcotic Pain Meds

  1. #1
    Member derek's Avatar
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    Constipation Relief when using Narcotic Pain Meds

    Hi. What are people using or doing when they have constipation due to using narcotic pain medications every day for nerve pain? I am using Oxycontin and Oxycodone each day in addition to Neurontin and Lamictal and the bowel movements just stop. Thanks.

  2. #2
    Senior Member
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    Raisins work for me, most of the time. But I don't use narcotics every day because they don't touch my neuropathic pain.

  3. #3
    Allbran brother,or as i call it twigs an sticks...i also eat activa yogurt and water ...good luck

  4. #4
    Senior Member watchthisbaby's Avatar
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    I stopped taking narcotics. Activia, Fiber One Cereal, and of course lots of water. Don't forget your exercise and to lay or sleep on your stomach as much as possible
    "We're one but we're not the same. We get to carry each other" U2

  5. #5
    Hi,

    I agree with all of the above.
    Also, are you on any type of bowel program (such as a sool softener, suppository,etc) for your SCI?

    AAD

  6. #6
    Senior Member alan's Avatar
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    This was posted years ago by pain doc William Work, who used to post in the Chronic Pain newsgroup. You could Google for a recipe for Senna tea, also.

    *******
    Laxative Use in Conjunction with Chronic Opiates

    You have been prescribed opiates (narcotics) to be taken daily.

    One of the most consistent side effects of chronic opiate use is constipation. This constipation is different than what you have probably had in the past. The difference is that this constipation cannot be treated by eating or taking extra fiber (like Metamucil) or by taking a stool softener (like Colace). The reason why this
    is so is that the medication you are now taking paralyzes your bowels. So while Colace may soften your stool quite well, it will not cause your bowels to empty.

    Therefore, you must take what is known as an "active" laxative on a daily basis to make sure that you have a bowel movement each and every day. You may not have been regular in the past, but you must be regular
    now.

    The three active laxatives that Dr. Work recommends are:

    1. Milk of Magnesia
    Take 2 tablespoons of this every night before going to bed. If you do not have a bowel movement the following morning, then you are to take another 2 tablespoons that morning. This is to be followed that evening by 2 more tablespoons. Normally, you will have a response to the Milk of Magnesia by the second or third dose.

    2. Dulcolax
    Take one capsule at night before going to bed. If you do not have a bowel movement the following morning, then you are to take another one that morning. This is to be followed by another capsule that night. Again, you should have a response to the Dulcolax by the second or
    third dose.

    3. Sennakot (or senna)
    Take 2 capsules at night before going to bed. If you do not have a bowel movement the following morning, then you are to take another two capsules that morning. This is to be followed by another two capsules
    that night. Again, you should have a response to the Sennakot by the second or third dose.

    If you ever "get behind" on your bowel movements (common during the first month of therapy as you get used to the medications and the active
    bowel regimen), then you should not "wait it out" and hope for the best. Drastic measures are needed to clean your bowels out and to then "start over." This can be accomplished by using magnesium citrate. This is
    sold over the counter at any pharmacy, in the laxative section, in a green glass bottle. This is a very powerful active laxative, aka " purgative," and should be taken in the following manner. Drink the entire bottle in one sitting. Just pour it into a cup and drink it. It may taste better if it is served chilled. It tastes like lemon-lime
    soda with a salty flavor. Once you have drank it, it will take anywhere from 1 hour to 12 hours to work. As it moves through your bowels, your abdomen will gurgle and you will feel and hear a lot of movement. This
    is normal and to be expected. Please do yourself a favor and do not go anywhere away from a nearby toilet until after the purgative has emptied your bowels. Once that is done, restart your previous, preferred laxative
    from the choices I had listed above. If you have had to do this twice, strongly consider changing your laxative choice to a different one.

    We joke about this all of the time, but it is no laughing matter to be constipated with a condition known as Opioid Bowel Syndrome and needing to
    be digitally disimpacted by a doctor or a nurse. So please take this as seriously as you do your pain relievers.

    Mag citrate and MOM and Sennakot and Dulcolax are all over the counter and lactulose is incredibly expensive (about $70 for an 8 oz bottle). Sorbitol can help to and is cheaper BUT you must be regular before you start
    using it. The gas it can cause will make you want to die if things get stuck.



    Laxative Use in Conjunction with Chronic Opiates

    You have been prescribed opiates (narcotics) to be taken daily.

    One of the most consistent side effects of chronic opiate use is
    constipation. This constipation is different than what you have
    probably had in the past. The difference is that this constipation
    cannot be treated by eating or taking extra fiber (like Metamucil)
    or by taking a stool softener (like Colace). The reason why this
    is so is that the medication you are now taking paralyzes your bowels.
    So while Colace may soften your stool quite well, it will not cause
    your bowels to empty.

    Therefore, you must take what is known as an "active" laxative on a
    daily basis to make sure that you have a bowel movement each and every
    day. You may not have been regular in the past, but you must be regular
    now.

    The three active laxatives that Dr. Work recommends are:

    1. Milk of Magnesia
    Take 2 tablespoons of this every night before going to bed. If you do
    not have a bowel movement the following morning, then you are to take
    another 2 tablespoons that morning. This is to be followed that evening
    by 2 more tablespoons. Normally, you will have a response to the Milk
    of Magnesia by the second or third dose.

    2. Dulcolax
    Take one capsule at night before going to bed. If you do not have a
    bowel movement the following morning, then you are to take another one
    that morning. This is to be followed by another capsule that night.
    Again, you should have a response to the Dulcolax by the second or
    third dose.

    3. Sennakot (or senna)
    Take 2 capsules at night before going to bed. If you do not have a
    bowel movement the following morning, then you are to take another two
    capsules that morning. This is to be followed by another two capsules
    that night. Again, you should have a response to the Sennakot by the
    second or third dose.

    If you ever "get behind" on your bowel movements (common during the
    first month of therapy as you get used to the medications and the active
    bowel regimen), then you should not "wait it out" and hope for the best.
    Drastic measures are needed to clean your bowels out and to then "start
    over." This can be accomplished by using magnesium citrate. This is
    sold over the counter at any pharmacy, in the laxative section, in a
    green glass bottle. This is a very powerful active laxative, aka "
    purgative," and should be taken in the following manner. Drink the
    entire bottle in one sitting. Just pour it into a cup and drink it.
    It may taste better if it is served chilled. It tastes like lemon-lime
    soda with a salty flavor. Once you have drank it, it will take anywhere
    from 1 hour to 12 hours to work. As it moves through your bowels, your
    abdomen will gurgle and you will feel and hear a lot of movement. This
    is normal and to be expected. Please do yourself a favor and do not go
    anywhere away from a nearby toilet until after the purgative has emptied
    your bowels. Once that is done, restart your previous, preferred laxative
    from the choices I had listed above. If you have had to do this twice,
    strongly consider changing your laxative choice to a different one.

    We joke about this all of the time, but it is no laughing matter to be
    constipated with a condition known as Opioid Bowel Syndrome and needing to
    be digitally disimpacted by a doctor or a nurse. So please take this
    as seriously as you do your pain relievers.

    Mag citrate and MOM and Sennakot and Dulcolax are all over the counter
    and lactulose is incredibly expensive (about $70 for an 8 oz bottle).
    Sorbitol can help to and is cheaper BUT you must be regular before you start
    using it. The gas it can cause will make you want to die if things get
    stuck.


    Laxative Use in Conjunction with Chronic Opiates

    You have been prescribed opiates (narcotics) to be taken daily.

    One of the most consistent side effects of chronic opiate use is
    constipation. This constipation is different than what you have
    probably had in the past. The difference is that this constipation
    cannot be treated by eating or taking extra fiber (like Metamucil)
    or by taking a stool softener (like Colace). The reason why this
    is so is that the medication you are now taking paralyzes your bowels.
    So while Colace may soften your stool quite well, it will not cause
    your bowels to empty.

    Therefore, you must take what is known as an "active" laxative on a
    daily basis to make sure that you have a bowel movement each and every
    day. You may not have been regular in the past, but you must be regular
    now.

    The three active laxatives that Dr. Work recommends are:

    1. Milk of Magnesia
    Take 2 tablespoons of this every night before going to bed. If you do
    not have a bowel movement the following morning, then you are to take
    another 2 tablespoons that morning. This is to be followed that evening
    by 2 more tablespoons. Normally, you will have a response to the Milk
    of Magnesia by the second or third dose.

    2. Dulcolax
    Take one capsule at night before going to bed. If you do not have a
    bowel movement the following morning, then you are to take another one
    that morning. This is to be followed by another capsule that night.
    Again, you should have a response to the Dulcolax by the second or
    third dose.

    3. Sennakot (or senna)
    Take 2 capsules at night before going to bed. If you do not have a
    bowel movement the following morning, then you are to take another two
    capsules that morning. This is to be followed by another two capsules
    that night. Again, you should have a response to the Sennakot by the
    second or third dose.

    If you ever "get behind" on your bowel movements (common during the
    first month of therapy as you get used to the medications and the active
    bowel regimen), then you should not "wait it out" and hope for the best.
    Drastic measures are needed to clean your bowels out and to then "start
    over." This can be accomplished by using magnesium citrate. This is
    sold over the counter at any pharmacy, in the laxative section, in a
    green glass bottle. This is a very powerful active laxative, aka "
    purgative," and should be taken in the following manner. Drink the
    entire bottle in one sitting. Just pour it into a cup and drink it.
    It may taste better if it is served chilled. It tastes like lemon-lime
    soda with a salty flavor. Once you have drank it, it will take anywhere
    from 1 hour to 12 hours to work. As it moves through your bowels, your
    abdomen will gurgle and you will feel and hear a lot of movement. This
    is normal and to be expected. Please do yourself a favor and do not go
    anywhere away from a nearby toilet until after the purgative has emptied
    your bowels. Once that is done, restart your previous, preferred laxative
    from the choices I had listed above. If you have had to do this twice,
    strongly consider changing your laxative choice to a different one.

    We joke about this all of the time, but it is no laughing matter to be
    constipated with a condition known as Opioid Bowel Syndrome and needing to
    be digitally disimpacted by a doctor or a nurse. So please take this
    as seriously as you do your pain relievers.

    Mag citrate and MOM and Sennakot and Dulcolax are all over the counter
    and lactulose is incredibly expensive (about $70 for an 8
    Alan

    Proofread carefully to see if you any words out.

  7. #7
    Member derek's Avatar
    Join Date
    Feb 2008
    Location
    Mercer Island near Seattle, WA
    Posts
    30

    Bowel Program

    SCI-Nurse, I only really started having to take the Oxycodone daily the past week or so. So, the constipation is just been a problem the past couple of days.

    The usual bowel routine for me since I left rehab 4 months ago was manual removal twice a day, morning and early evening. The laxative method didn't really work for me so I stopped that after rehab. I don't think I can give up my Oxycodone since my pain is just getting unbearable so maybe I will try the Milk of Magnesia before bed.

    I have tried getting off the Oxycodone for a couple days awhile back and had normal bowel movements a day or so later.

  8. #8
    My wife uses polyethylene glycol (Miralax); she also gets extra fiber from Citrucel.
    - Richard

  9. #9
    Hi!
    I have done Oxycodone before. I was taking one tablet at night before getting back into bed.. mini vacation I found that if I drank enough water, and tailored my diet a bit, I was ok to take the Oxy for a week or two, one tab every night. (I do not like physical addiction, so I do not take it anymore, except on a very rare occassion, and then one night is it)
    nikki
    T6 complete since Oct, 2001
    TiLite ZRa, Spinergy LX 24", Shox Firm tires, 3" volcanic glare rollerblade wheels for casters

  10. #10
    Senior Member Mona~on~wheels's Avatar
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    250 mg magnesium twice a day w/meals

    ground flax seed

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