One almost universal side effect of opioids is constipation. Unlike other side effects, such as sedation and euphoria that tend to dissipate over time, constipation generally persists no matter how opioid-tolerant a person might be. The same is true of meiosis, an extreme narrowing of the eye’s pupil. This article will discuss the following question: what are remedies for opioids and constipation?
Why do Opioids Cause Constipation?
This condition occurs because opioids affect receptors not only in the brain but in the stomach and intestines, too. The opioid molecules attach to receptors in the gut and slow them down, preventing them from doing their job of moving food along the intestinal tract. This effect, while reversible, can be so profound that people stop taking the opioid they may need for pain. This is not necessary. There are many medications and dietary solutions for opioid-induced constipation or OIC. It should be noted that opioids do not permanently alter intestinal function. When the opioid is stopped (or blocked with certain medications) normal function returns within a day or two.
That said, opioids can cause severe constipation. Although there are many jokes about this condition, it’s not funny and can even be life-threatening.
Does Diet Help?
Before trying prescription medications for OIC and risking their side effects, a trial with diet and an over-the-counter medication called docusate sodium may help. Individuals with high blood pressure may not be able to take docusate, but it’s generally well tolerated. Always ask your physician before starting any new diet or medication.
Docusate is a stool softener. It works by attracting water to the intestinal area and softening the stool, making it easier to pass. Although it’s typically not too effective for constipation caused by OIC, it’s worth a try. Combine docusate with high-fiber foods like oatmeal and carrots. Be sure to drink plenty of water.
Prescription Medications for OIC
There are a number of highly effective medications available on prescription for OIC. These work by blocking the effects of the opioid on the receptors in the gut. The main problem with these medications is that they sometimes reduce the opioid’s pain relief as well. They can also cause opioid withdrawal symptoms.
Prescription meds for OIC are only supposed to work in the gut. They’re not supposed to enter the brain and cause a reaction there. However, some people do experience withdrawal symptoms while taking these specialized meds for OIC. It’s one of the risks but probably not a risk that should stop you from trying one of these medications. If you have a problem, you can always stop taking it. On the other hand, it may clear up the constipation problem for you without compromising your pain relief. While these medications are not known to cause birth defects, the actual effect of them on a developing infant are unknown at this time.
Movantik (naloxegol)
Naloxegol is a peripheral opioid blocker. This is in contrast to a central opioid blocker, which can enter the brain and reverse the effects of opioids. Examples of these would be naltrexone and naloxone. However, a peripheral opioid blocker is only supposed to work outside the brain. Naloxegol may cause stomach pain and should not be used by anyone with a prior intestinal blockage.
Amitiza (lubiprostone)
This is not an opioid blocker. Instead, it works by increasing the amount of fluid in the intestines. This drug is used to treat chronic constipation caused by different factors and also irritable bowel syndrome.
Relistor (methylnaltrexone)
This is another peripheral opioid blocker. Unlike its chemical cousin naltrexone, methylnaltrexone cannot cross the blood-brain barrier.
Symproic (naldemedine)
This is also a peripheral opioid blocker. Along with the others of its class, it should not be used in patients with severe cancer pain.
If you Need Help
If you’d like to know more about medications for OIC, just call us anytime at 833-820-2922. We’re here 24 hours a day to answer all your questions and refer you to resources in your area.