Sorry for the over simplication, but what I said is basically true. Opiates work the same way in the colon as they do in the brain and the CNS. Not exactly a shutdown, but in some ways close enough.

Below is a quote from "knowswhy.com" which is the first place I could quickly find that briefly explains the situation. http://www.knowswhy.com/why-do-opiates-cause-constipation/

"Opiates affects the bodys Central Nervous System (CNS) as well as the gastrointestinal tract by binding with opioid receptors which blocks the pain signals before it reaches the brain. Opiates then creates a numbing effect in the body because of the reduced sensitivity to pain or reduced response to pain in the nerves."

You're generalizing 1 condition for an extremely varied group, which should never be done, because it's not accurate.

I've been on narcotic or opiate meds since I was 20, I'm now 45. I've been on multiple Narcotics daily for the last 10 years along with various BiPolar meds, NSAIDS, Muscle Relaxers, Blood Pressure meds, Daily Antibiotics, Anti-Seizure meds, HRT meds, Steroids, Cluster Migraine meds and several other things.

I've also had 30 surgeries in the last 15 years along with countless procedures, tests, etc.

I have a Degree in Accounting, a Degree in Computer Science, a Ph.D in Clinical Psychology and am a Certified Paralegal. I've worked since the day I turned 16 and still work. I'm an Accountant with a 25 hr/wk corporate job and also have several Private Accounting Clients.

....and my point is, my brain despite the fact that it likes to get screwed up and have Seizures and Cluster Migraines that can last up to 13 days at a time, is, was, and always has been working pretty well. Oh yeah I forgot to mention the 3 Cycles of ECT I've had as well.

My PM Dr. whom I've seen for almost 16 years now has always checked up on my bowel habits to make sure things are working as they should. My Neurologist and Psychiatrist also routinely ask about my bowel habits.

It's not "truth" "that most Dr.'s are clueless about OIC" I've seen Pain Management Dr.'s in 3 different States over the last 25 years and they've always made sure I was educated on possible constipation issues from the Narcotics.

Taking a group of Patients that have as varied and complicated medical issues as Chronic Pain patients do and saying all their Dr.'s will be ignorant about Narcotics and Constipation is just wrong, as is saying all their brains will "shut down" from taking meds through the years.

First, let me apologize for the term "shut it down" when referring to the brain. Obviously, this was an oversimplification that if actually true, would mean, for one thing, that this board would become very quiet. My point was that opiates work in other parts of the body similar to the way they work in the brain for pain; by binding to opioid receptors in tissues such as the GI tract. I am concerned that people don't realize that opiate induced constipation (OIC) is very different than constipation suffered by people not on medications. Many do not, I promise.

Doctors, my favorite subject: Katlyn, your experiences seem to be 180 degrees out-of-phase with what we have found. I also have a PC doctor, pain doctor, and a psychiatrist, and my wife also has a neurologist. With the exception of the pain doctor, who I will get to next, not a single one has ever mentioned this problem. I even attended a 30 day outpatient pain clinic and this subject was covered for 30 minutes and nearly everything that she said was completely wrong for treating OIC. Following her advice could have put everyone in the ER.

My (and my wife's) pain doctor's nurse always asks during our brief pre-doctor arrival interview if we have constipation and naturally we always answer "yes." But that is always the end of it (never discussed when the doctor arrives, which always begged the question; why ask us in the first place?). Finally, during one of our visits, I asked the doctor about what he recommended to his patients for OIC, and his response, and I quote; "isn't there something at the drugstore that starts with an S?" (Unquote). Well, I knew to stop right there because he did not have a clue and he works in a large orthopedic surgeon's office with boatloads of surgeons and pain patients. He is a great doctor though, even with this minor flaw.

Since the cause of OIC is different than standard constipation, then the treatment is usually much different and more aggressive (laxatives vs. just diet changes, for example). If not treated correctly, OIC can lead to the ER because of becoming impacted like my aunt did a few weeks ago. She had had back surgery and was taking some kind of opiate pain medication. She was not told about OIC, or how to treat it, and suffered the consequences; became impacted. (She lives in another part of the country BTW, but familiar story to me.)

Another example: My father died of prostate cancer on 9/20/13. For pain he was taking Vicodin, PRN, for several months. (I still cannot believe how little pain medication he took the last several months of his life.) During this time, while under treatment from an oncologist and later in hospice care, he became constipated from the small amount of Vicodin he was taking. Neither he, or my mom (who had taken over his medical authority) had been given any advice on his problem except maybe to drink some fiber stuff (which is exactly the wrong thing to do). Therefore, I had to explain to my mother (via phone since I live in TX and they live(d) in IN) what he really needed. In his case; just lactulose. When she asked the hospice doctor about it, he first acted like he had never heard of it, although nursing homes, and hospitals, use it all the time. I am sorry that I have digressed, but as you can probably tell I am still a little "raw" on this subject.

The bottom line for me, everyone has to look out for their own health issues because nobody else will because of many things; limited time being a big factor IMO. On this specific subject, I have studied this for nearly three years because of the lack of any real, or accurate, help from doctors. Not a single doctor has mentioned the constipation, or when asked, gave us the correct information about OIC. Yes, I may have generalized in my other posts, but it is very important that anyone taking narcotic pain medications be prepared for non-stop constipation, having to deal with it every day, and receiving conflicting information on how to solve it. Many, I am afraid, have no idea what they are getting into. Also, if they do look for solutions for constipation they will find/read the recommendations for standard constipation, which almost never ever mention the fact that if opiate medications are involved then all bets are off as are the recommendations.

Again, I am sorry for overstating the brain connection. However, I hope that people who are fighting this problem download the paper in my first post. You WILL know more about OIC than nearly every doctor, or at least 100% of the doctors that I and my family members have seen the past few years.

Steve

I'm going to post about miralax/PEG/Polyethline Glycol. I took it for about 10 months then got a BURNING BLADDER...called IC. Ic-network .com is a site for us who have suffered. Yahoo has a group called MIRALAX also. Learn before you get hurt. Yes it was nice going every morning like clockwork. But there was a bad smell when starting it...I THINK that was because it stripped the lining of the colon...or seemed to have for me. And my bladder. And others. Read and judge for yourselves. I wanted to share as people on here have helped me a lot and I wanted to return the favor. I was on with another name..anne I had to delete my email due to hacking and so I just made an new account. Well I just wanted to say. We have to be careful. I began adding cascara and a veggie health food drink to soften...and use senna for the 'go'. I wish I had more info on fentanyl patches causing less constipation. I'm on oxycodone and afraid to ask dr. for a change. He might leave me on it and it not work as well. You know how funny docs can get.
Well my best to you all. I'll start a post so all can see this. Thanks. Take care.

Since I like to go the natural route when possible. I take licorice capsules and and Ayrevedic formulation call Triphala. Both are available at the health food store.

I take cod liver oil on a daily basis and my doctors prescribed Miralax for long term constipation. It is the safest and doesn't cause your bowels to rely on it like the rest of them. You can use the Miralax every day until you get a normal bowel going and then every third day if needed. It can be prescribed if you have insurance or found at Wal Mart and just about any drug store, although it will cost more at the drug stores. . Good luck and I hope it works for you. Hugs GB