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As many of you know Opiates and non steroidal antiinflammatory drugs are associated with constipation.
I wanted to post about why this happens AND discuss some treatments of drug induced constipation:
1) Opiods affect all segments of the stomach and intestine (particularly the colon) altering GI neural input, inhibiting motility and increasing fluid absorption. Additionally opiates may increase the absorption of electrolytes and water, increase anal sphincter tone and reduce sensitivity to the presence of stool = all contributing to constipation and hard stools
2) FIBER AND BULK LAXATIVES (psyllium, bran, citrucel, etc) are GENERALLY NOT EFFECTIVE FOR THE TREATMENT OF MEDICATION INDUCED CONSTIPATION
3) STIMULANT LAXATIVES (senna and bisacodyl which is dulcolax) increase intestinal motility and help with the efflux of water IN to the bowel which improves constipation. SENNA is more commonly used and slightly more effective than BISACODYL (Dulcolax) for opiod induced constipation.
4) OSMOTIC LAXATIVES: These include Magnesium or Phosphate containing laxatives and nonabsorbable sugars (lactulose, sorbitol, glycerin) and polyethylene glycol (Miralax).
They increase fluid accumulation in the colon and small intestine which improves constipation and ARE EFFECTIVE FOR TREATMENT OF OPIATE INDUCED CONSTIPATION. Some data show that lactulose is better than sorbitol and that Miralax is better than lactulose....
5) EMOLLIENT LAXATIVES: This includes colace (docusate) or mineral oil and are inferior when used for the treatment of Medications induced constipation than the osmotic and stimulant laxatives
Hope this helps
Dr O.
I wanted to post about why this happens AND discuss some treatments of drug induced constipation:
1) Opiods affect all segments of the stomach and intestine (particularly the colon) altering GI neural input, inhibiting motility and increasing fluid absorption. Additionally opiates may increase the absorption of electrolytes and water, increase anal sphincter tone and reduce sensitivity to the presence of stool = all contributing to constipation and hard stools
2) FIBER AND BULK LAXATIVES (psyllium, bran, citrucel, etc) are GENERALLY NOT EFFECTIVE FOR THE TREATMENT OF MEDICATION INDUCED CONSTIPATION
3) STIMULANT LAXATIVES (senna and bisacodyl which is dulcolax) increase intestinal motility and help with the efflux of water IN to the bowel which improves constipation. SENNA is more commonly used and slightly more effective than BISACODYL (Dulcolax) for opiod induced constipation.
4) OSMOTIC LAXATIVES: These include Magnesium or Phosphate containing laxatives and nonabsorbable sugars (lactulose, sorbitol, glycerin) and polyethylene glycol (Miralax).
They increase fluid accumulation in the colon and small intestine which improves constipation and ARE EFFECTIVE FOR TREATMENT OF OPIATE INDUCED CONSTIPATION. Some data show that lactulose is better than sorbitol and that Miralax is better than lactulose....
5) EMOLLIENT LAXATIVES: This includes colace (docusate) or mineral oil and are inferior when used for the treatment of Medications induced constipation than the osmotic and stimulant laxatives
Hope this helps
Dr O.
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My 6mo twin DD's are EBF and just started rice cereal on the first. Everything has been going fine except this morning one of them had a diaper rash (lots of redness around her anus). I read this as one of the signs of an allergy. BUT I did just buy a different brand diaper yesterday (which they have used randomly before w/no issues). Do you think its the cereal or the diaper? Im ready to start...
Thanks so much for your post
pinkpamther
I have lived through a colon blockage, and remember the pain as being as painful as labor. Not something I ever want to endure again.
I use miralax, which I call "Doctor Rob's Magic Elixar" because it works so well. No Worries here.
Great having a Dr to educate us!
Fybrochik
I have purchased so many over the counter meds for this, none of them seem to work.
I have increased my fruit intake and have been drinking a ton of fruit juices instead of soda. So far im not seeing a positive change.
I will try a few of the idea's u posted.
thank u
I plug up the toilet up at least 2x a week but I have found nothing that will make them normal again. I just live with the senna and the pain while have a B/M. My doc just keeps telling me steamed veggies and you'll be fine. Well it doesn't work. I have to have senna or I am not going to have a good day.
1) For more resistant cases of opiod-induced constipation Magnesium hydroxide and magnesium sulfate (both osmotic laxatives and both with VERY forceful and quick effects) are an option
Dr O.
Thanks
pink