Managing Constipation

Opioids slow down your gut and draw water out of your stool (poop). This makes your stool hard and difficult to pass, which is called constipation. Constipation is the most common side effect of opioids.

If you notice that your bowel movements are smaller, harder, or less frequent than usual, you are constipated. Constipation often makes people feel bloated and uncomfortable. It can lower appetite, cause nausea (upset stomach), belly cramps, and worsen pain.

Constipation can be a vicious cycle: the longer you wait to treat it, the harder it is to get moving again. Believe it or not, if constipation gets bad enough it can even send a person to the hospital. Don’t worry, we’re here to help so that it doesn’t become a big problem for you.

Stool becomes hard

Stool is difficult to pass

Water leaves stool

Stool stays in rectum longer

Constipation

Laxatives help break this cycle!

Here are some helpful tips for staying regular:

Sometimes laxatives can work too well, and you may have loose stools or diarrhea. If this happens, stop the laxatives until your diarrhea has been gone for about a day.

When your diarrhea has been gone for about a day then restart your laxatives at a slightly lower dose (Tap for specific advice about how to adjust laxatives).

Don’t make the mistake of stopping your laxatives completely: this can cause the “yo-yo” problem where you become very constipated again, you need high doses of laxatives, then the yo-yo swings in the opposite direction towards diarrhea.

Without laxatives, it’s hard to get your stool moving. Here are some other things you can do in addition to laxatives that may help:

Drink a lot of fluids. Aim for 8 cups per day. Any fluids (except alcohol) count! It can be water, soup, juice, milk, tea, or any drinks you like.
Pay attention to other medications. Some medicines can make constipation worse. These include common anti-nausea medicines like ondansetron (Zofran), palonosetron (Aloxi), and granisetron (Kytril). If you find that these medicines make your constipation worse, try increasing your laxatives on the days you need to take them. You can also talk to your care team about other anti-nausea medicines that don’t cause constipation.
Be active! Even walking slowly for 5-10 minutes at a time can help move things through.
Eat more fiber in your food. Try raw fruits and vegetables, oatmeal, or other whole grains. Some fiber-rich foods (like broccoli or cabbage) may cause gas and bloating, so listen to your body and notice what helps and what doesn’t. Tap to learn more about nutrition and constipation.
Foods to avoid: Try not to eat too many foods that cause gas, like cabbage, broccoli or fizzy drinks. Also, try to limit the amount of foods you eat that cause constipation like meats, cheese, chips, fast food, or processed foods like hot dogs or some microwave dinners.
Avoid fiber supplements: This sounds confusing, but most fiber supplements (like Metamucil or Citrucel) can make the stool bigger and harder to pass. So - experts say when taking opioids, STAY AWAY from fiber supplements all together.