Medications for pain, called opioids, are normally prescribed following an intensive surgery (especially for pain or cancer-related problems). However, frequent uses can sometimes lead to opioid-induced constipation (OIC). This common side effect can happen to anyone, and the different treatment options for it will vary from person to person.
Treating for OIC may be as simple as changing lifestyle factors, or as complicated as taking several types of medicine and laxatives. Below we will dive into the various treatment types, as well as where to look for them.
Changing Lifestyle Factors to Treat Opioid-Induced Constipation
The earliest recommendations for treating opioid-induced constipation is changing up the normal lifestyle routine. It is important to understand that foods, liquids and daily activity contribute to resolving anybody “problems”. These factors include:
- Increasing exercise for daily energy expenditure
- Increasing fluid intake (mostly water)
- Increasing dietary fiber
- Increasing time for bathroom breaks
However, these lifestyle changes may not be possible for many patients. Age, daily priorities, physical obstacles and other factors could inhibit those with OIC with a natural treatment. In addition, these changes may not even be effective in treating for OIC. There may be other underlying medical issues which may need to be treated separately with medication or treatment programs.
Drugs and Medications that Treat Opioid-Induced Symptoms
When lifestyle changes do not treat OIC effectively, the next thing to consider is taking medicine to help. These medications will normally be prescribed alongside the opioid, often the moment the opioids are given so side effects of constipation can be treated immediately. However, most of the time these drugs, called laxatives an/or cathartics, are only given after signs of OIC.
Cathartics will accelerate defecation, where laxatives ease it. By softening the stool and allowing those to “go” sooner, it removes all of the uneasiness that comes with constipation.
- Bulk Cathartics – Increases the bulk-ness of stool
- Emollient or Lubricant Cathartics – Softens and lubricates the stool in the intestinal tract.
- Osmotic Laxatives – Increase the amount of water and fluids in the abdominal region, which increases bulk and softens stool.
- Prostaglandins or Prokinetic Drugs – Changes the way the intestines absorb water and electrolytes and increase the weight and frequency of stools while decreasing transit time.
- Stimulant Cathartics – Directly counteracts the effects of opioid medication by increasing intestinal motility, which helps push the stools along in the gut.
With these different treatments, approved prescriptions include:
- Naloxegol (Movantik) – This medication is used to treat chronic constipation for those with ongoing pain that is not caused by cancer. It blocks the effect of narcotics in the gut without blocking the effect on pain treatment.
- Methylnaltrexone (Relistor) – This treatment helps restore bowel function for those who have an advanced illness and receive opioids for pain relief. Delivered as an injection under the skin, Methylnaltrexone specifically targets opiate-induced constipation by displacing the opioids from binding to receptors in the gut.
- Lubiprostone (Amitiza) – Administered orally, Lubiprostone causes an increase in the secretion of fluids into the intestines. This fluid softens the stool and may need speed up the transit time for stool.
When To Get Professional Help for Opioid-Induced Symptoms?
While opioids can reduce the severity of pain, there is always a risk of side effects, especially for constipation. If lifestyle changes, home remedies and over-the-counter medicines don’t work, the next step is to speak with a doctor. Speak with Scottsdale Internal Medicine today if you are experiencing these symptoms, or learn more about opioid-induced symptoms with our related links below.