One of the most frustrating and common side effects of narcotic pain medication is constipation. In fact, many patients stop taking these medications simply because they have trouble having a bowel movement. Constipation is no laughing matter and can cause severe digestive disruption and stomach cramps. Although many types of laxatives are on the market, they can sometimes be confusing for a patient who just wants relief.
Constipation can be handled in a number of different ways. First, nutrition and other dietary behaviors often have a profound effect on the course of constipation. Second, you can use an over the counter laxative, but you need to know exactly what each type does for the body. Finally, you can use more invasive methods to affect a bowel movement, but these are generally reserved for extreme cases.
If you are considering a different approach to pain management because of this side effect, using the following strategies can relieve painful cramps, help you move your bowels and still control your pain.
Nutritional Strategies for Constipation
Constipation is a hardening of the stools that results from a lack of water in the large intestine. Although your small intestine is primarily used to absorb nutrients from food, your large intestine is responsible for absorbing primarily water. When it absorbs too much water, you stool gets hard, and this prevents it from moving through the colon and eventually passing from the body.
One of the easiest fixes for constipation is simply to drink more fluids, preferably water. This will add bulk to your stool, decrease hardened stools, and help you pass them more easily.
The other nutritional component in the constipation puzzle is dietary fiber. There are certain types of foods, such as vegetables, that are not completely broken down by the processes of digestion. These foods still provide a benefit because they add bulk to the stool, cleanse the colon, and assist with normal bowel movements.
You should aim to get at least 25 grams of fiber per day, preferably from your diet and not a supplement. Many nutritious high fiber foods and candy bars are available, and eating one of these per day can sometimes make your cramps and constipation problems disappear.
Types of Laxatives
Laxatives come in four different types, and each one has specific actions on the bowel to produce a bowel movement. It is important to know the different types so you can make the best choice. The first type of laxative is a bulk forming laxative, and it is essentially a fiber supplement. These are medications, such as Metamucil, that are taken daily if you do not get enough fiber in your diet. They are not usually effective for active constipation, but are used regularly to maintain bowel function. You should note that you must increase your water intake with this type of laxative for it to be effective.
The second type of laxative is known as the osmotic laxatives, and they work by stimulating the large intestine to pull more water into the colon. This helps the stool become more liquid, and therefore, easier to pass. Lactulose and milk of magnesia are two examples of this type. They are generally gentler on the digestive system, and they can be taken for a current constipation problem. They generally tend to work on the intestine overnight and produce a bowl movement the next day.
The third type of laxative is the one that is most commonly thought of when considering medications to relieve constipation. These are the stimulant laxatives, such as Exlax or Ducolax. Certain herbal preparations, such as Senna, are also considered stimulant laxatives and relieve cramping. Essentially, they stimulate the large intestine to contract and expel the stool from the body. These are usually effective within a few hours, but you should take care in using them. If you take them too often, your bowel can become accustomed to them, and you will be unable to have a bowel movement without taking a laxative.
The fourth type of laxative is the stool softener. This merely helps the stool become softer and easier to pass. Some examples of this kind are Colace and Doxinate. They are generally gentle enough to take every day. Some doctors will even prescribe stool softeners to be taken once or twice daily as a preventative measure for constipation from pain medications.
Check with your doctor about prescribing you this medication if you have chronic constipation. Otherwise, you can get it over the counter, but you should not use it for more than a week continuously without your doctor’s permission.
When Laxatives Fail
Sometimes following dietary behaviors and using a laxative by mouth does not help the constipation. In this case, the next step would be to use a suppository. Many suppositories have the same action as the oral laxatives. Some stimulate the large intestine to contract, and some force the large intestine to pull in water from surrounding tissues.
The other types of suppositories coat the stool in an emollient, such as mineral oil, to help them exit the body. The important point to note with suppositories is that they must be allowed to dwell inside the large intestine for a while. Insert the medication as directed, but resist having a bowel movement for as long as possible. This will allow the medication to work more effectively.
The final type of over the counter remedy for constipation is an enema. Although this does not sound pleasant, it is often quite effective in achieving a bowel movement. Again, it is important to allow the enema solution to stay in your body as long as possible. This gives it the chance to work on the stool and the surrounding organs.
You should not use enemas or suppositories on a regular basis because they can cause the bowel to resist moving on its own. Only use them as prescribed by a doctor if you have a chronic constipation problem from pain medication.
If you have pain that is severely impacting your life, such as back pain or fibromyalgia disability, the professionals at SoCal Pain Center can help. We can prescribe you pain medications, physical therapy, and injections that make you feel your best.
If you are currently fighting the problem of constipation from pain medications, we can help with that, as well. Contact us today for a consultation.