When opioids attach to receptors in your gut, it lengthens the amount of time it takes stool to pass through your gastrointestinal system. Constipation is defined as having fewer than three bowel movements a week. Anywhere from 41 to 81 percent of people who take opioids for chronic, noncancer pain experience constipation. There are medications and natural and home remedies that can help you find relief. Mineral oil is a lubricant laxative that also helps stool move through the colon. An enema or suppository inserted into the rectum may soften stools and stimulate bowel activity.
Prescription medication specifically for OIC should treat the problem at its root. These medications block the effects of opioids in the gut and help stools pass more easily. Prescriptions approved for the treatment of OIC include:. Speak with your doctor if you experience side effects. It may help to modify your dosage or switch to a different medication.
Fiber has a laxative effect because it increases water absorption in the colon. This forms bulkier stools and helps stools pass easier. Bulk-forming fiber supplements include psyllium Metamucil and methylcellulose Citrucel. Although fiber supplements are an effective remedy for constipation, more studies and research are needed to confirm the efficacy of fiber supplements for OIC.
You should eat between 25 to 30 grams of fiber per day. Take one to three tablespoons daily of Citrucel or use Metamucil up to three times a day. Be sure to follow the directions on the Citrucel or Metamucil product you use.
Fiber supplements can decrease the absorption of some medications such as aspirin. Talk with your doctor before combining a fiber supplement with any prescription medications. Aloe vera may also relieve OIC. In one study , rats were given an oral administration of loperamide to induce constipation. Consider using a dietary tracker that includes water tracking. Generally, we are aware of the official recommendation to eat five servings of fruits and vegetables daily.
Many of us do not even get this minimal amount of healthy natural foods. When you are making plates of fruits or vegetables or when you are making a salad, look for the colors that you include.
It is good to have a variety of natural, fiber-rich ingredients with various colors. Bell peppers, tomatoes, cucumbers, lettuce, and much more can give you a healthy rainbow of delicious vegetables that make up a healthy salad.
Fruits are also important. Be certain that you eat the fruit whole and not as a juice. When fruits are juiced, the healthy and important fibers that can help improve constipation are removed from the fruit. A diet rich in fiber helps to increase the roughage passing through your intestines. This, combined with good fluid intake will help to overcome constipation difficulties.
Are you often home, sitting on the couch or laying in bed? Do you avoid going out for a walk or jog? How about a swim? Exercise gets your body moving. This is good for a variety of reasons. Exercise keeps your metabolism elevated and it helps to maintain your weight. In addition to these benefits, walking every day keeps your intestines moving and active. This, in turn, improves your general bowel health and helps to keep food and waste moving along through your system.
Daily regular exercise can make a difference in improving problems with constipation. First, you can try the above described natural solutions. Try drinking more water during the day.
When you do not have enough water passing through your intestines, you will be more likely to be constipated. Also, walking, jogging and other forms of moderate exercise can help to get things moving.
Another thing you can try is to increase the fiber in your diet. Fruits and vegetables are healthy and they contain fiber. Eating a salad every day is a good idea for everyone. The exception is that if you have an intestinal condition that makes eating fiber-containing foods unsafe, you should take care and follow the specific dietary recommendations of your doctor.
For example, diverticulosis is such a condition where eating too much fiber and seed-containing foods might be dangerous, putting you at risk for an acute case of diverticulitis. Many meds that help to resolve constipation are available over the counter in the pharmacy. There are products such as Colace, magnesium citrate or magnesium sulfate, Dulcolax bisacodyl , milk of magnesia, mineral oil, castor oil, Mylanta, Miralax or ClearLax polyethylene glycol , Gas-X simethicone , Senokot, BeneFiber or Metamucil, acidophilus, and probiotics.
Docusate sodium is the ingredient in Colace and other brands. Docusate is a stool softener. It should not be taken if you already use mineral oil. In addition to oral forms of docusate, it is also available as an enema. Senna is a laxative derived from an herb. Both leaves and fruit from the herbal plant are used to make senna-based medications. Senokot is an example of a medication based on senna.
Senna can be used in combination with psyllium or docusate sodium. Magnesium, in addition to helping with constipation, also helps with muscle cramps. Magnesium is a supplement that may also be helpful to reduce the severity of some symptoms of opioid withdrawal. Even though you do not need a prescription for these meds, it is still important to discuss them with your doctor before taking them.
Your pharmacist can also be helpful in making decisions about OTC meds. Even though these medications do not require a prescription, you might still want to ask your doctor for a prescription if you have health insurance.
It is possible that having a prescription will get your insurance company to cover the cost. There is a relatively new medication for opioid-induced constipation, Movantik, also known by the generic name, naloxegol. Some patients who have Suboxone constipation find that this unique medication helps. Your doctor may even consider other prescription constipation meds.
For example, there is also methylnaltrexone, known by the brand name, Relistor. The names, naloxegol and methylnaltrexone may sound somewhat familiar. They are chemically related to the opioid blockers, naloxone and naltrexone, respectively. These two drugs work by blocking opioid receptors in the gut. When an opioid drug, including the buprenorphine in Suboxone or ZubSolv, activates intestinal opioid receptors, the ongoing movement of the muscular intestinal walls is reduced.
Waste material, or feces, passing through the large intestine does not get pushed through as quickly. As a result, excess water is removed, causing the stool the poop to become dry and hard, making it even more difficult for it to pass through and leave the body. Opioids have also been found to decrease the emptying of pancreatic juice and bile, which can lead to delayed digestion. Short-acting opioids like heroin and oxycodone cause temporary symptoms of constipation, but because the effects only last for a short duration, uncomfortable side effects eventually subside.
Suboxone, on the other hand, is a long-acting opioid, meaning it remains in the system for a longer period of time. Because Suboxone takes effect in the body for days at a time with regular dosing, symptoms like constipation will likely last much longer than with short-acting opioids.
Those with opioid-induced constipation often deal with uncomfortable responses in the body and GI tract. These symptoms might begin immediately after treatment starts or gradually as a person continues to use Suboxone. Many patients stop using Suboxone altogether because the effects on the GI tract are unbearable. These will increase the bulk of the stools, but opioids like Suboxone will prevent this increased bulk from moving through the system, worsening abdominal pain and bowel obstruction.
Suboxone is an effective treatment method for opioid use disorders. Addiction Resource aims to provide only the most current, accurate information in regards to addiction and addiction treatment, which means we only reference the most credible sources available. These include peer-reviewed journals, government entities and academic institutions, and leaders in addiction healthcare and advocacy. Enemas can be store-bought kits, or improvised home remedies. There is no shortage of online information on enemas.
Tip: Warm enema to around degrees Fahrenheit before use. If an enema is not enough, don an exam glove, lubricate with mineral oil or petroleum jelly, and yes, reach in with a finger or two to manipulate the stool. Separate small pieces at a time and slowly work through the mass until it is small enough to pass entirely.
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