Just a little bit of harm reduction here...
I used to be into tramadol, using doses 400mg and more, spread throughout the day. As my tolerance got higher, so did the number of pills I was taking. Then I noticed I wasn't going to the bathroom (BM) like I used to. I thought nothing of it, I'll go when i have to go. A week and a half later, I get the feeling that I have to go, so I sat and it literally took me an hour and I was in a ton of pain. Once I finally passed it, i couldn't believe it (I wish I had a scale for a before and after weigh, lol). Of course, I noticed and freaked out a bit when I saw traces of blood on it and on me. After doing some research, I determined that it would heal itself (it did) but the best thing for constipation is to get ahead of it. Eat whole wheat.... everything- bread, pasta, waffles, powerbars. Take a few spoonfuls of knock off Metamucil (psyillium husk) when you can fit it in. Of course, if you're taking pills throughout the day, this could be hard as you don't want to take any meds 2 hours before or after something like that. But thinking of how much that first one hurt.... I drank that stuff like it was my job. Of course, I still got constipated a little or sometimes if my diet was bad and I forgot to supplement, I'd know I would not want to pass this thing. Fortunately, I discovered Milk of Magnesia which works relatively quickly and is pretty safe (non-addicting.... I know, it's slightly amusing to think your colon could get "addicted" to a laxative when i was around popping pills left and right and didn't worry about addiction).
Moral of the story... we know opiates constipate, some of us more than others and tramadol certainly fits in this category. Don't wait until it's too late and you're faced with passing a stool the size of a small child, get in front of it with whole wheat food, supplements, "stool softener", anything that can help.
And don't forget, when I stopped using them I got to enjoy the reverse effect, but aside from the occasional sprint to the bathroom, it wasn't as bad as the first issue. Also, Loperamide is so easy to take and effective, it's SO helpful.. Fiber supplements are a bit harder to take as you have to time them right, and down that filling liquid, even if you're not hungry. Anyway, just a personal anecdote that carries a little message, but a very important one. Take care of your digestive system
-SpinningFree