Constipation from Opioids (Narcotics)

?

 

Narcotic pain medicine causes constipation in most people.  This medicine slows down bowel movements moving through the intestine. This causes the stool to become hard.  If you have hard bowel movements, have trouble passing bowel movements, and the movements are not often enough, then you have constipation. 

 

This can be a problem.  It may last as long as you are taking narcotic medicine. So, it is important to learn how to prevent and treat constipation.  

 

What can I do to prevent constipation?

 

An ounce of prevention is worth a pound of cure.  Make a plan to avoid this problem.  Stick to it as long as you are taking narcotic pain medicine.  Review your plan with your doctor or nurse.  Here are some things to include in your plan.

 

• Eat foods that have helped you to relieve constipation in the past.
• Eat foods high in fiber or roughage.  This includes foods such as uncooked fruits, raw vegetables, and whole grain breads and cereals.  Try prune juice.  Buy some unprocessed bran and add 1 or 2 tablespoons to your food.  Keep a shaker of bran handy at mealtimes and sprinkle it on foods.  If you are not hungry, do not force yourself to eat fiber.
• Drink plenty of liquids.  Eight to ten 8-ounce glasses of fluid each day will help keep your stools soft.  Warm liquids often help your bowels to move.  Have a warm drink about half an hour before your planned time for a bowel movement.
• Exercise as much as you are able each day or at least every other day.  Increase the amount you walk.  Check with your doctor or nurse about the exercises that are best for you.
• Plan your bowel movements for the same time each day, if you can.  Set aside time for sitting on the toilet or commode.  The best time is after a meal.

 

What about stool softeners and laxatives?

 

Many people taking narcotic pain medicine need the help of a stool softener.  This alone may not work.  You may need to add a gentle laxative.  Be sure to check with your doctor or nurse before taking any of these on your own. 

 

Your doctor or nurse may suggest taking a laxative on a regular schedule rather than waiting for constipation to happen.  There are many types and brands of laxatives, and most need no prescription.  Talk to your doctor about which may work best for you, and at the best price.

 

What about bulk laxatives and fiber, like Metamucil®?

 

Bulk laxatives and fiber like Metamucil® absorb water and expand to increase bulk and moisture in the stool.  They are not the best to use for constipation from narcotics.  They should only be used if you are able to drink plenty of fluids throughout the day. 

 

What about suppositories and enemas?

 

Both can be used as an added step to treat constipation.  It is not a good idea to rely on enemas as part of a regular plan to avoid constipation.  Talk to your doctor or nurse before using either of these options.

 

What are the important points in my plan?

 

• Put together a plan to prevent constipation and stick to it as long as you are taking your narcotic pain medicine.
• Do not stop taking your pain medicine even if it is harder to control the constipation than it is to control the pain.
• Aim for a bowel movement every second or third day rather than every day.
• Call your doctor before taking any stool softeners or laxatives.

 

What are examples of high fiber foods?

 

Cereals and flours	Bran cereals, whole-wheat bread, rye bread and crackers, wheat germ, corn, cornmeal, wild rice, brown rice, barley, popcorn
Fruits	Fresh, canned, or dried fruits, especially those with skin or seeds (apples, plums, pears, peaches, tomatoes, berries, raisins, and dates)
Vegetables	Any raw or cooked vegetable (not overcooked) such as carrots, cabbage, peas, dry beans, and lentils

 

 

High Fiber Home Recipes

 

Fruit Pudding

 

1-2 tablespoons one to three times a day

 

Pudding recipe: (in blender combine)

3 oranges peeled

4 apples with skins

2 cups raisins and dates

2 cups prunes

add prune juice to consistency of sauce or pudding

 

Can keep in refrigerator 7-10 days, can be frozen

 

Bran Muffins

 

1-2 muffins daily

 

Bran muffin recipe:

2 ½ teaspoons baking soda

½ quart buttermilk

2 ½ cups flour (1 ½ whole wheat; 1 white)*

1 cup sugar

½ package (15 oz.) Raisin Bran cereal

1 teaspoon salt

2 eggs slightly beaten or 1 cup egg substitute

½ cup oil

* ½ cup wheat germ may be substituted for ½ cup whole-wheat flour

 

Combine all ingredients.  Bake in greased muffin pans at 400° for 18 to 20 minutes. Makes two dozen muffins.

 

Spanish version is Health Facts for You #6043.

 

References

American Pain Society (2004). Clinical Practice Guideline: Management of Cancer Pain in Adults and Children. Glenview, Il.

 

 

The information provided should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed physician should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Any duplication or distribution of the information contained herein is strictly prohibited.

Last Updated: 11/24/2010

Copyright © 11/24/2010 University of Wisconsin Hospitals and Clinics Authority. All rights reserved. Produced by the Department of Nursing. UWH #4843

Print Health Fact For You