If you’re taking an opioid for pain, you might have noticed your bathroom trips getting slower. That’s opioid‑induced constipation (OIC), a common side effect that can be frustrating and uncomfortable. The good news is you don’t have to live with it – a few easy changes and the right medicines can bring back regularity.
Opioids bind to receptors not only in the brain but also in your intestines. When they latch onto these receptors, they tell the gut muscles to contract less and tighten the sphincters. The result is slower movement of stool, more water absorption, and harder, drier poop.
Because these drugs also reduce the feeling of urgency, you might ignore the natural urge to go, making the problem worse. The effect can show up within a day of starting the medication and can last as long as you stay on the drug.
Hydrate. Aim for at least eight glasses of water a day. More if you’re active or live in a hot climate. Water softens stool and keeps the colon moving.
Fiber boost. Add soluble fiber (oats, apples, beans) and insoluble fiber (whole wheat, veggies, nuts) to each meal. Start slowly to avoid gas, and pair fiber with plenty of fluid.
Move. Simple walks after meals can stimulate the bowels. Even 10‑15 minutes of light activity can make a difference.
OTC laxatives. Bulk‑forming agents (psyllium) work with fiber, while stool softeners (docusate) add moisture. Stimulant laxatives (senna, bisacodyl) should be used short‑term and only if other steps haven’t helped.
Prescription options. If over‑the‑counter fixes don’t work, ask your doctor about peripherally acting μ‑opioid antagonists like methylnaltrexone, naloxegol, or naldemedine. These medicines block opioid receptors in the gut without affecting pain relief.
Timing. Take your laxative or stool softener at the same time each day, preferably before bedtime, so you can have a morning routine.
Talk to your doctor. Never stop or change opioid dosing on your own. Your prescriber can adjust the dose, switch to a different pain medication, or add a bowel regimen tailored to you.
Remember, OIC is a signal that your body needs a little extra help. By staying hydrated, loading up on fiber, moving regularly, and using the right medicine, you can keep constipation under control while still getting the pain relief you need.
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