Opioid Constipation

One of the most common conditions caused by opioid use is constipation. Although it may not sound like a serious side effect to some people, the condition is often the most prevalent component of opioid-induced bowel dysfunction, or OBD, and can cause extreme discomfort. There are many uncomfortable symptoms shared between OBD and constipation, including straining, dry and hard stools, incomplete evacuation, and abdominal distension and bloating. In addition, OBD also can cause nausea, vomiting, cramping and gastric reflux.
Opioids including OxyContin, Percodan, Demerol, Vicodin, Percocet and Opana can all cause opioid-induced constipation. Of the several negative side effects experienced from opioid use, constipation is the most widespread and can be very uncomfortable. It generally affects at least 41 percent of patients who take opioids over an extended period of time. But, in a study by Robinson et al. 2000, 95 percent of oncology patients that were on an opioid pain-control regimen reported constipation as the major side effect of their treatment.
It’s believed that the opioid receptors within the walls of the bowel are responsible for causing constipation in opioid patients. The drugs interfere with the normal contraction and tone of the bowels, delaying the movement of stool. Many physicians will often recommend certain lifestyle changes to help prevent constipation, including increasing dietary fiber, fluid intake, and physical activity or exercise. The issue however, is that some patients may not be physically able to make these lifestyle changes, and in many cases these changes are not enough to combat opioid-induced constipation. It’s important to note that bulk-forming laxatives are not recommended for opioid-induced constipation as the biological function that moves stool through the bowels (peristalsis) is repressed in these patients.
Often times, additional medications are prescribed to treat opioid-induced constipation. Laxatives and cathartics are generally prescribed simultaneously with opioids so that constipation is addressed at the onset of opioid treatment. A cathartic speeds up defecation, while a laxative is intended to soften the stool and ease defecation.
If you or a loved one are starting an opioid treatment plan or are experiencing discomfort cause by your opioid treatment plan, we encourage you to consult your medical professional.  If you are unsure or need assistance deciding the best treatment option, please feel free to contact us for further guidance.