Opioids are drugs or medications that are similar in effect or structure to opium. They are used most commonly to treat moderate to severe pain. One common side effect of opiate use is constipation. It is important to consult a physician for management of disease, opioid use and side-effects.
Use of Opiates
Opiates are used to treat acute and chronic pain. Conditions such as cancer can be quite painful and require daily use of powerful pain medications such as opiates. Chronic daily use, while useful for pain management, will also be most likely to cause side-effects such as constipation.
Mechanism and Side-Effects
Opiates work by binding to opiate receptors. These receptors normally bind to the naturally occurring endorphins in the body. The result is decreased pain and possibly a sense of euphoria. Unwanted side-effects are common and include constipation, sleepiness, fatigue, trouble thinking, nausea, vomiting, itching, muscle twitching and respiratory depression.
Frequency
Many of the side-effects of opiates are overcome with chronic use, as the body becomes accustomed to the effects of the medicine and compensates for their occurrence. Constipation is not among these, however. It is a persistent side-effect and the most common of all the side-effects, often causing a person to decrease the dose, with a resulting increase in pain.
Treatment
Constipation should be prevented as much as possible by using a high fiber diet supplemented with senna. Other stool softeners such as docusate and lactulose may also need to be given. Increased fluids in the diet can also help if it does not interfere with other medical conditions. However, fiber and increased fluids can worsen some conditions, such as bowel obstruction, so these approaches should be undertaken with the help of a physician. Other medications include polyethylene glycol and sorbitol. If these are ineffective, methylnatrexone can be used. This drugs blocks the effects of opiates on the intestines without being absorbed.
References
- "Current Opinion in Supportive and Palliative Care"; "Management of constipation in palliative care patients."; Clemens K.E., Klaschik E.; 2008
- "Harrison's Principles of Internal Medicine"; Anthony S Fauci et al.; 17th Ed 2008
- "Miller's Anesthesia"; Ronald D. Miller MD, Lars I. Eriksson, Lee A. Fleisher MD, and Jeanine P.
