One of the side effects of pain medications are what we delicately like to call…gastrointestinal issues (GI). They can range from ulcers/inflammation after taking anti-inflammatories (aspirin, ibuprofen) up to and including ’stoppages’ that result from the use of opioids (codeine, vicodin, tramadol).
It is in the second area that patients can find themselves faced with inaccurate information – even from doctors. The rational solution to treating stoppages is to recommend fiber supplements and more water. But that may not work on patients taking pain medications – their problem is that the pain medications paralyze the stomach ‘muscles’ – throwing more ’stuff’ at those muscles can lead to more problems (and in some cases bowel obstructions). Added to this is that when most doctors think of ‘GI’ complications in connection with pain medications, they only think of constipation. The patient may have other problems associated with opiod use such as delayed gastric emptying (the food stays in your stomach while the rest of the plumbing works fine). Again, tossing more fiber and water into a stomach that cannot process existing food leads to….unpleasant results (gastroparesis). There is still much misinformation when it comes to managing pain medication side effects.
The solution? This article spells out in detail how to manage GI problems related to opioid use. Simply put – patients should make certain that before they start taking pain medications, that they *are* getting enough fiber and water. Then, as soon as they start taking opioids, they should also take stool softeners every day along with a stimulant laxative every 2-3 days (or as needed.) And in spite of what many GI doctors claim, the article points out that the use of regular stimulant laxatives to manage opiod side effects will not automatically ‘ruin’ your stomach or bowels and will not make you ‘dependent’ on laxatives forever.
Go here for the full article “Managing Opioid Induced Constipation”
