Any medication i can use to get rid of constipation?

[legaluser]

Constipation caused by chronic opiate use? I saw a commercial for something on the TV but cant remember the name, anyone else who uses opiates alot able to tell me what i can do to keep shitting normally lol.

 

[Kittycat5]

I think the commercial is for Movantik. It is basically naloxone attached to PEG which decreases its permeability into the CNS and only works in the gut. There is also a drug called Relistor which is similar but expensive and injectable.

Ive always recommended stool softeners like docusate first but recently read some stuff saying opiate induced constipation is better treated with a stool softener/laxative combo like Peri-Colace. Miralax is also a good option as it too has stool softening and laxative effects.

 

[legaluser]

hm sounds like some good info ima look into all these, I hate having to shit bricks....literally.

 

[Kittycat5]

Good luck, that constipation can be down right painful. I know exactly how you feel.

 

[Nom de Plume]

I would be surprised if this is the most effective type of drug for constipation, but amphetamines seem to regularly restore regularity for me.

Given a soupçon of d-amphetamine, and within 45 minutes I'll be sprinting to the nearest latrine for a satisfying shit.

 

[legaluser]

well ive been using gabapentin to help combat constipation, since it gives you the squirts, it works somewhat but not all the time for some reason.

 

[Kittycat5]

I would be surprised if this is the most effective type of drug for constipation, but amphetamines seem to regularly restore regularity for me.

Given a soupçon of d-amphetamine, and within 45 minutes I'll be sprinting to the nearest latrine for a satisfying shit.

Interesting. It seems amphetamines can go either way, ie causing diarrhea or constipation. Did you use it, Nom de Plume, to ever combat constipation induced from opioids?

 

[《Plasticity》]

Plugging low doses of amphetamine or any of it's derivatives guarantees that I will go, but this is a last resort. As far as something to take daily I would ask your doctor for docusate, it's what I was given. You can also take magnesium citrate along with it to ensure regularity. IME though diet plays the largest role in the severity of constipation, even when opioids are involved.

Since revamping my diet to all vegetables, fruit, whole grains, and lean protein I've been very regular despite my opioid use. I'm sure adding flax seed to your diet would help as well due to fiber content. For acute constipation there are OTC enemas and weak stimulant based laxatives at local drug stores (in the US at least).

 

[legaluser]

I think the commercial is for Movantik. It is basically naloxone attached to PEG which decreases its permeability into the CNS and only works in the gut. There is also a drug called Relistor which is similar but expensive and injectable.

Ive always recommended stool softeners like docusate first but recently read some stuff saying opiate induced constipation is better treated with a stool softener/laxative combo like Peri-Colace. Miralax is also a good option as it too has stool softening and laxative effects.

I heard stool softeners and laxatives dont really work since the 'mu' / 'it looks like a pie symbol' however you spell it, receptor because opiods bind to make your gut just stop working or really really slow, so a laxative wont get it all out just a small part of it out .

 

[Kittycat5]

Well it depends. The activity of activating the mu receptor in the GI tract causes many varied responses. They decrease motility, lessen fluid secretion, and increase muscle tone among other things. Laxatives work in opposition of many of these effects, even if they do not directly bind to opioid receptors. Let me try and find the info I was talking about.

 

[Nom de Plume]

Interesting. It seems amphetamines can go either way, ie causing diarrhea or constipation.

Verily. However, I should say that amphetamines have never actually given me diarrhea. Rather, they simply seem to shorten the time it takes to expel matter after having ingested it.

In other words, these drugs merely shorten the time spent between sitting at the table enjoying dinner and sitting on the toilet enjoying a dump.

Did you use it, Nom de Plume, to ever combat constipation induced from opioids?

Yes. While I very rarely partake of opioids, I can recall using amphetamines to effectively treat opioid-induced constipation during the few times I have ever had it.

For example, one time I had taken 40 mg oxycodone and had found myself desperate for a BM some hours afterward.

But even my best efforts of strenuous straining seated upon the stool (giving up only after my lower extremities became numb and tingly) were totally unavailing. It was bad enough that I began to grow anxious and quite hysterical (as I have been known to be in a panic), thinking I'd never defecate again and ultimately die of an oversized fecal impaction.

Then, I took 60 mg dextroamphetamine (not for the constipation, but just to feel high). I was amazed at the rapid effectiveness with which the drug had relieved the acute constipation; even where OTC stool softeners and laxatives had failed me, amphetamines did the trick with ease.

I went from a tortuous 10 hour-long case of backed-up bowels and agonising abdominal distention to a nice and pleasurable 2 hour-long shit-releasing sojourn in the reading room.

 

[dez79]

For some reason nicotine gum n diet coke works for me lots of both

 

[Johndoedoe.junk]

IME just making sure that you're regular and take a shit once or twice a day you're good. Others may have a different experience. Miss a day or worse two and your in for it!

 

[Kittycat5]

We should probably make a distinction between constipation that is not chronic after opioid ingestion and true opioid induced constipation. If you either sporadically use opioids and get constipated or only occasionally get constipation while on long term opioid therapy, things like lifestyle modification and laxative use probably will suffice.

However, true OIC is a different ballgame. It does not seem to be dose dependent and rarely spontaneously resolves. If you have it, you are stuck with it. The first line standard of care still is laxatives. Combos of stool softeners and stimulant laxatives is probably best as they will increase water secretion into the bowel and stimulate motility. These would include senna/docusate products but bisacodyl + docusate is probably more effective. As mention Miralax may be useful on its own and of course there are always saline enemas for rapid relief.

But these approaches fail in up to half of OIC sufferers and is why things like Movantik (naloxegol) and Relistor (methylnaltrexone) have been introduced, with others in the pipeline. They truly counteract the effects of opioids in the GI system and I imagine will soon be the gold standard of treatment.

 

[DixiChik]

Is the Movantik expensive? Linzess worked for me, but it costs $258 per month. Who can pay that?

I have IBC, so constipation is all I know. Introduction of opiates for PM has caused some life-threatening situations. Eleven days without BM while taking MS Contin, yet my PM doctor never warned me.

I'm currently taking Oxycodone. I use ALL of the methods listed in previous posts, rotating as needed. STILL, due to surgically altered intestines and adhesions, it's an impossible scenario.

 

[Kittycat5]

Pretty expensive. Not sure the exact cost but will find out.

 

[Felonious Monk]

Senekot

I know kitty mentioned it but I was not clear the OP had even tried laxatives.