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    Opiates/opioid constipation? 
    #1
    My main problem with this is not so much the constipation itself it is the pain and bleeding caused by passing the stool.

    Where as a normal stool is smooth and solid and evenly shaped and easily passed, those produced while using opiates are voltron like abominations.
    Many smaller pieces of stool form together to be an uneven shape that is often too big to even be passed without manually breaking it up as it emerges, not to mention the dry nature of them that makes them difficult to pass.

    Its hard to even find a lot of information on opiate constipation beyond the basics, does anyone know what causes these much smaller feces to form and then bond together? The common things like stool softeners and fiber don't help the fact that instead of a solid even long stool instead there is a lumpy mass too large to pass without damage.

    I know this subject is verboten among most for the embarrassing nature, but this to me is easily the most serious complication to opiate use.
    Has anyone found anything that helps prevent this weird problem?

    There is a helpful graphic demonstrating what I mean, on the left is a normal stool and on the right the opiate induced anus buster.
    Last edited by garuda; 06-02-2008 at 14:26.
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    #2
    Bluelighter ratgirl's Avatar
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    "opiate induced anus buster". My new favorite saying!

    teasing, teasing, I feel your pain. And unfortunatley, I've never seen any helpful info on the problem...I've always just chalked it up to one of the less pleasant aspects of opiate use.

    I admire your use of paintshop, btw!
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    #3
    oes anyone know what causes these much smaller feces to form and then bon
    It's called constipation. Opiates slow down your digestive system, particularly by slowing down your intestines. This is because you have opiate recepetors (Mu, which is also are the primary receptors in your brain responsible for making opiates enjoyable, and are responsible for euphoria, killing pain, and releasing histimines) in your stomach that, when activated, trigger your gut to slow down.

    When 'stuff' in your stomach isn't moving as much, it builds up to cause constipation. This is also why when you do opiates, you won't need to use the bathroom until much later than normally, because 'stuff' doesn't reach the 'end' till later than usual.

    Small, compact feces are a form of constipated stool.

    However if you are bleeding when you shit, you should seek medical attention. Bleeding means an extreme form of constipation, and may have to do with things other than drug use. Take a two day break from opiates at the least, and if you are still bleeding you should seriously seek medical attention.

    Laxatives and antibiotics like pencillion, mynocin, etc will help with your constipation as well.
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    #4
    Bluelighter LightTrailz's Avatar
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    penicillin eh .. i might have to give that a try . any idea on dosage? i have a bunch left from when i got tosilitis
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    #5
    Depends how much drugs you use, your diet, among other things.

    Whatever dose you take will help, how much is perfect amount depends on a lot of things. You're supposed to only take on of whatever antibiotic is in question when prescribed because too many can upset your stomach though, so I wouldn't take anymore than 2.
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    #6
    To elaborate I have experienced constipation unrelated to opiates, but its nothing like opiate constipation. I understand the cause I was just wondering if anyone had any tips or tricks beyond laxatives or stool softeners as they really don't help the core problem which is stools too weirdly shaped to pass normally. Staying hydrated and eating a normal amount doesn't help.

    The bleeding is from small tears in my anus from passing the bizarrely shaped masses, its not any large amount but is painful and annoying. they are also painful for some days before healing. I honestly hate doing it but I have resorted to manually breaking it up as it "emerges".

    I know the obvious answer is stop taking opiates, but we all know how that goes

    Was just looking for any tips or tricks anyone had, or if anyone faced my particular problem. Something that could keep the small compact feces from joining together would be perfect. I'm open to anecdotal cures and home remedies.

    Yes I realize how embarrassing and gross this subject is, but I figure someone has to broach the topic heh.
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    #7
    I take Morphine and Oxy for chronic pain (daily for 5+ years). I could have drawn your photo shop exhibit myself -- perfect display of what has happened to me. I am not having bleeding, just extreme discomfort when having a BM.

    I have started a regimen a few months ago that has helped a lot -- better than the laxitives the doctor gave me. I stopped seeking relief from my pain doctor when he said, "we might need to ease up on the medicine some, if its causing severe constipation". I immediately said, "its really not that bad Doc.". and never mentioned it again to him. My doctor laughed and said "thats the quickest cure for constipation I have ever seen". When the doctor asks me each month how my bowels are, I answer, "perfect Doctor -- Thank you for asking".

    Back to your problem. Here is the "cure".
    Its expensive on a daily basis:

    Metamucil - gradually worked up to 2 to 3 doses per day, every day.
    Fish Oil Capsules 1000 mg. x 6 capsules per day. (double the suggested dose).
    Co-Q10 100mg. x 1 capsule per day.
    Dry Roasted Almonds 25 to 30 daily as soon as I wake up.
    ABOVE HELPS A LOT (much better than stool softners doctors gave me).

    If I do the above, PLUS the following, I am almost back to "Normal" (prenarcotics):

    Eat 1 apple per day.
    Eat 1 banana per day.
    Eat 1 (homemade) Bran Muffin per day. (My wife buys a HUGE bag of Bran flour at a mill. The muffins have raisins also and about 120 calories per muffin.
    Drink a couple of BIG glasses of water per day.

    It takes all 8 of the above steps, EVERY DAY just to get back to normal.

    If I was young (high school / college) and starting to experiment with Oxy and friends, I would seriously re-consider what I was doing after reading this thread. If NOT for severe pain, I could stop the opiates just due to the problems with constipation. It took the fun out of pain meds very quickly after I realized how hard it is to treat it.

    Good luck with it!
    Willie
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    #8
    Bluelighter ratgirl's Avatar
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    what about adding acidophilus? The regime that willie(?) posted seemed pretty good. And as he said, Water!!! Lots! But I've found that acidophilus (either naturally found in yogurt w/ active cultures or in supplement form) helps my constipation/IBS/insane digestive system. sometimes. kind of.
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    #9
    this has been covered a lot before.


    my best solution is magnesium. depending on if you use a fuckton, it synergizes with the high too. (it's a nmda antagonist at high doses, but it gets water into your intestines to help your shit, too).
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    #10
    Bluelighter Sportfisher39's Avatar
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    Capsule
    I drink lots and lots of water everyday. I've noticed if I drink little water my stool is dryer and harder. But if I drink lots of water a day it makes my stool more smooth and softer, and not so hard on my ass when I'm trying to shit.
    By lots of water I mean I drink 2 32oz bottles of water a day
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    #11
    I feel your pain - except that I have a nice case of hemorrhoids to worry with as well. I find Milk of Magnesia to work extremely well.

    Below is from a hand-out from a pain management doctor. Hopefully you might find a few words of wisdom in it:

    Laxative Use in Conjunction with Chronic Opiates

    You have been prescribed opiates (narcotics) to be taken daily by Dr. W.

    One of the most consistent side effects of chronic opiate use is
    constipation. This constipation is different than what you have probably had
    in the past. The difference is that this constipation cannot be treated by
    eating or taking extra fiber (like Metamucil®) or by taking a stool softener
    (like Colace®). The reason why this is so is that the medication you are now
    taking paralyzes your bowels. So while Colace® may soften your
    stool quite well, it will not cause your bowels to empty.

    Therefore, you must take what is known as an "active" laxative on a daily basis
    to make sure that you have a bowel movement each and every day. You may not
    have been regular in the past, but you must be regular now.

    The three active laxatives that Dr. W recommends are:

    1. Milk of Magnesia®
    Take 2 tablespoons of this every night before going to bed. If you do not
    have a bowel movement the following morning, then you are to take another 2
    tablespoons that morning. This is to be followed that evening by 2 more
    tablespoons. Normally, you will have a response to the Milk of Magnesia® by
    the second or third dose.

    2. Dulcolax®
    Take one capsule at night before going to bed. If you do not have a bowel
    movement the following morning, then you are to take another one that
    morning. This is to be followed by another capsule that night. Again, you
    should have a response to the Dulcolax® by the second or third dose.

    3. Sennakot® (or senna)
    Take 2 capsules at night before going to bed. If you do not have a bowel
    movement the following morning, then you are to take another two capsules
    that morning. This is to be followed by another two capsules that night.
    Again, you should have a response to the Sennakot® by the second or third
    dose.

    If you ever "get behind" on your bowel movements (common during the first
    month of therapy as you get used to the medications and the active bowel
    regimen), then you should not "wait it out" and hope for the best. Drastic
    measures are needed to clean your bowels out and to then "start over." This
    can be accomplished by using magnesium citrate. This is sold over the
    counter at any pharmacy, in the laxative section, in a green glass bottle.
    This is a very powerful active laxative, aka "purgative," and should be
    taken in the following manner. Drink the entire bottle in one sitting.
    Just pour it into a cup and drink it. It may taste better if it is served
    chilled. It tastes like lemon-lime soda with a salty flavor. Once you have
    drank it, it will take anywhere from 1 hour to 12 hours to work. As it
    moves through your bowels, your abdomen will gurgle and you will feel and
    hear a lot of movement. This is normal and to be expected. Please do
    yourself a favor and do not go anywhere away from a nearby toilet until
    after the purgative has emptied your bowels. Once that is done, restart
    your previous, preferred laxative from the choices I had listed above. If
    you have had to do this twice, strongly consider changing your laxative
    choice to a different one.

    We joke about this all of the time, but it is no laughing matter to be
    constipated with a condition known as Opioid Bowel Syndrome and needing to
    be digitally disimpacted by a doctor or a nurse. So please take this as
    seriously as you do your pain relievers.

    Mag citrate and MOM and Sennakot and Dulcolax are all over the counter and
    lactulose is incredibly expensive (about $70 for an 8 oz bottle). Sorbitol
    can help to and is cheaper BUT you must be regular before you start using
    it. The gas it can cause will make you want to die if things get stuck.

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    #12
    Almost forgot - this same doc has a pretty good recipe for daily maintenance:


    DOSE: 1-2 Tablespoons per day

    1 pound prunes
    1 pound raisins
    1 pound figs
    4 oz. senna tea (health food store.. it looks like a bunch of leaves)
    1 cup brown sugar
    1 cup lemon juice

    1. Prepare tea..use about 2 1/2 cups boiled water added to tea
    and steep 5 minutes.
    2. Strain tea to remove tea leaves and add only 1 pint tea to a
    large pot, then add fruit.
    3. Boil fruit and tea for 5 minutes.
    4. Remove from heat and add sugar and lemon juice. Allow to
    cool.
    5. Use mixer, blender or food processor to blend fruit mixture
    into smooth paste.
    6. Place in plastic container and place in freezer. (Paste will
    not freeze but will keep forever in freezer.)
    7. Spoon out what you require each day.

    Enjoy eating it straight off the spoon.

    Spread it on toast or add hot water and make a drink.

    If the fruit paste is not working, (you are not having bowel movements), then you need to increase the amount of fruit paste you are taking. On the other hand...if you have very loose stools, then you need to cut down on the amount of fruit paste you are taking. Perhaps even taking it every other day works.
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    #13
    Bluelighter Dragynfyr's Avatar
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    Go on ebay and look for some of those chips fried in that special oil that got pulled off the market years back =p
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    #14
    Bluelight Crew qwe's Avatar
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    that picture made my day

    and i know how you feel
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    #15
    Bluelighter uNhoLeee's Avatar
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    fiber, get some unsalted nuts and go..well... nuts.
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    #16
    You could do an enema or drink mineral water, but don't do that every day, only if you like need to shit real bad. Using them daily can cause deficiencies in natural nutrients in your body like vitamins and minerals.

    The following foods help, include these in your diet.


    * Unprocessed wheat bran
    * Unrefined breakfast cereals
    * Whole wheat and rye flours
    * Grainy breads, such as whole wheat, rye or pumpernickel
    * Fresh fruits
    * Dried fruits, such as prunes, apricots and figs
    * Vegetables
    * Legumes, such as chickpeas, baked beans and lima beans
    Also, Metamucil helps. You can drink it every day and it's quite tasty! Probably find it at health stores, or maybe at CVS/Walgreens by like supplements and vitamin section.
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    #17
    Bluelighter LightTrailz's Avatar
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    I just drink around 10-12 bottles of water per day . and it normally helps me stay regular under my opiate usage it may take a few days but it comes eventually and is never hard to pass what so ever . only if i dont hydrate myself often is when i have issues my self . but i also dont eat alot either as im on a diet .
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    #18
    Bluelight Crew sonic's Avatar
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    Fiber + caffeine is all I've ever needed.. I usually take it in the form of methyl cellulose. Just 1-2 pills per day keeps me semi-regular and makes going to the bathroom much less painful. Fiber doesn't actually make you go, but it loosens your stool. If you haven't gone in a while.. AFTER you've been taking fiber, just take a diuretic such as caffeine to make you go.
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    #19
    Bluelight Crew sonic's Avatar
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    Quote Originally Posted by Dragynfyr
    Go on ebay and look for some of those chips fried in that special oil that got pulled off the market years back =p
    You're talking about olestra and they never pulled it off the shelves. They just had to put an unappealing FDA warning on their products which caused the demand to go way down. However, I think the actual bowel issues it caused were over-hyped.
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    #20
    Bluelighter zzITCHY420zz's Avatar
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    wow man it's not just the constipation causing u problems..it's probably the lack of good diet as well , leading to hard unhealthy shits. if u dose in the morning, perhaps you should try waiting, drinking a good cup of coffee, and see if that does anything. eat alot of cereal (not now, but add it in your diet if it isnt already in it), and for the moment perhaps you should consider using a fiber supplement as well. good luck man
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    #21
    Bluelighter Dragynfyr's Avatar
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    Quote Originally Posted by sonic
    You're talking about olestra and they never pulled it off the shelves. They just had to put an unappealing FDA warning on their products which caused the demand to go way down. However, I think the actual bowel issues it caused were over-hyped.

    How did they put it, 'oily stool' something something 'anal leakage'? lol If something like what he drew was trying to plow its way through my ass I think a bit of chip induced lube would be a good thing
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    #22
    Bluelighter
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    I would say drink a lot of water.... when I was going through chemo and was put on oxy I got so backed up it was rediculous.... I didnt poop for about 8-10 days so I ahd to go to the hospital and get pumped with laxatives.... I later ofund out that water was the key
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    #23
    ATTN: GARUDA. This is the most important post you will read.

    What you have developed is known as an anal fissure and they're more common than you think. They can be very mild and easy to heal with a few small, short-term diet and lifestyle changes or they can be so bad that they require surgery.

    To heal an anal fissure you absolutely must do everything in your power to significantly soften your stool and keep it that way for at least a week, the longer the better. The best way to do this is with the use of stool softeners, laxatives, heaps and heaps of fibre and water and abstinence of opiates/opiods. Obviously, the latter is hard for you, but if getting high is more important than the well-being of your body then you seriously have a problem. Plus the bonus will be the fact that your tolerance will drop in the meantime.

    Another very useful remedy is nitroglycerin ointment. This works by helping to avoid anal sphincter spasm which helps the tissue to heal significantly.

    You should also check out this Anal fissure self-help page (http://www.boardsailor.com/jack/af/). It has heaps of information which I am sure you will find useful.

    Hope it works out for you.
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    #24
    stool softeners are available otc almost everywhere, a bottle of 100 is like 5 bucks, take 1 and in like 5 or 6 hours your problem should be gone. I've had the same problem man so I feel your pain man, it sucks to have real hard poop that hurts like hell to come out, like litterally on occasion i have been screaming in pain. The stool softener really helps and has a built in gentle laxative quality so any constipation will be gone.
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    #25
    He said stool softeners alone haven't worked for him.
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