Treatments for Opioid-induced Constipation

Over-the-counter and prescription medications that help relieve and treat OIC.

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Constipation 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.

open toilet and toilet paper

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.

To learn about foods that can help improve constipation, view our slideshow, 7 Dietary Tips Help Opioid-Induced Constipation.

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.

Stimulants
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 are two prescription products approved for OIC treatment—methylnatrexone and naloxegol.  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.

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: 07/19/17
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Gary W. Jay, MD, FAAPM
This article was reviewed by Gary W. Jay, MD, FAAPM.
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