Treatments for Opioid-induced Constipation

From Laxatives to New Medications that Treat the Root OIC Cause

Peer Reviewed

MedicationsConstipation is an often-seen side effect of taking opioids that may have been prescribed to help manage your severe chronic back or neck pain. When the constipation occurs as a direct result of the opioids, it is called opioid-induced constipation, or OIC, which is very similar to—though slightly different from—typical constipation (often called “functional constipation”).

There are several treatment options available for OIC, and this article will outline the common management choices your doctor may recommend for your condition.

Once your doctor has diagnosed you with having OIC, the next step is recommending treatments that would be most suited to your lifestyle and back pain or neck pain (and other medical conditions). Treatments run the gamut from basic, at-home changes like diet and exercise, to over-the-counter laxatives and prescription medications.

Possible Opioid-induced Constipation Treatment:  Diet and Exercise
Watching what you eat and being sure to include high-fiber foods may help your OIC. In addition, exercise and drinking lots of water can be beneficial. These actions work to stimulate your intestines and can help move stool along.

However, before starting any exercise regimen, talk to your doctor to make sure any fitness options you choose won’t worsen your chronic back pain or spinal condition. Also, too much dietary fiber can lead to a bowel obstruction, so let your doctor know which foods and supplements you eat on a regular basis and he or she can tell you if a change in diet is right for you.

Over-the-Counter OIC Options
There are several treatments for OIC available at your local pharmacy or drug store.  These treatments are also used for functional constipation.

In OIC, the use of stimulants can be beneficial in helping the stool pass more easily through the intestine. They work by triggering muscles in the intestinal wall to tighten, squeezing the stool and propelling it forward. Before trying stimulants, though, be aware that they can aggravate and inflame your intestinal lining. If you feel any abdominal pain or distress after taking a stimulant for OIC, let your doctor know.

Lubricants and Hydrating Agents
Hydrating agents and lubricants increase your stool’s water content. Stool with more moisture is oilier and has an easier time of passing through the intestine. As a result, in the first eight hours after taking the product, you may have a bowel movement.

Stool Softeners
With OIC, you’ll often experience discomfort and straining when trying to have a bowel movement. Stool softeners may help, as these products give your stool a slipperier consistency. This makes it easier for your stool to pass through the intestine. It’s important that, when taking a stool softener for OIC, you make sure to drink plenty of water.

Prescription Medication Specifically for OIC
Opioid-induced constipation may share some signs and symptoms with functional constipation, but its root cause is different.  OIC is caused by the way opioids interact with your digestive tract, and there is currently only one product approved for OIC treatment—methylnatrexone.  Opioids can affect the nerves that go to your bowels, which can slow down the action of the bowels, so methylnatrexone works by reducing the opioid effects on the digestive system.

Methylnaltrexone is available as a subcutaneous injection that you can take once every other day, or up to once every 24 hours, if you need to.

There are several clinical trials underway in the United States that are examining medications for the condition. These study results should provide the medical community with more treatment options for managing OIC.

As always, before starting any treatment regimen, be sure to consult your doctor.  You may think you’re experiencing functional constipation, but if you’re using opioids for your chronic back pain or chronic neck pain, it may be opioid-induced constipation.  Your doctor will take into account your spine condition and lifestyle when suggesting an opioid-induced constipation treatment plan for you.

Updated on: 06/02/16
Continue Reading
Opioids for Severe Back Pain and Neck Pain
Gary W. Jay, MD, FAAPM
This article was reviewed by Gary W. Jay, MD, FAAPM.
Continue Reading:

Opioids for Severe Back Pain and Neck Pain

Opioids treat severe pain. However, they have a negative stigma of addiction and substance abuse. When taken as directed, opioids are a safe and effective treatment option for relieving severe chronic back pain and neck pain.
Read More