Opioid-induced constipation: Causes, symptoms, and treatment – Medical News Today

Healthcare professionals prescribe opioids to treat pain due to a number of conditions and especially during the later stages of cancer. While opioids are very effective in providing pain relief, these medications can cause constipation and other side effects.
People take opioids to manage different types of pain. Opioid-induced constipation (OIC) can cause further discomfort, which can affect a person’s quality of life.
OIC treatments include natural remedies and over-the-counter or prescription medications.
This article discusses the link between opioids and constipation, OIC symptoms, and treatments for OIC.
Opioids bind to specific proteins in the body called opioid receptors. The brain, spinal cord, and gastrointestinal tract all contain these receptors.
By binding to these receptors, opioids block the brain’s ability to perceive pain. However, opioids also depress or slow down the central nervous system.
The central nervous system oversees how the body responds to pain. It also controls involuntary movements, including those of the digestive tract.
For this reason, taking opioids can result in constipation.
Medications that cause OIC contain substances such as morphine, codeine, oxycodone, and methadone.
Common medications that cause OIC include:
Common gastrointestinal symptoms of OIC include:
Several treatments can help ease OIC. They include lifestyle changes, medication, and natural remedies.
Lifestyle changes can include dietary and behavioral modifications. Some lifestyle changes that may help alleviate OIC include:
Over-the-counter and prescription medications may also help. A healthcare professional may prescribe preventative medication when they prescribe an opioid to a person.
Over-the-counter OIC medication options include:
The American Gastroenterological Association Institute recommends traditional laxatives as a first-line treatment for OIC. The organization provides guidelines for medical management of OIC when over-the-counter laxatives do not provide relief.
These prescription medications can help ease constipation experienced with opioids:
In addition to drinking more water, eating more fiber, and getting exercise where possible, some natural ingredients may also help relieve OIC. These include:
Consult with a healthcare professional or pharmacist before taking herbal remedies, as they may interact with or decrease the effectiveness of certain medications.
A healthcare professional may recommend a person take over-the-counter fiber supplements, such as Citrucel, Metamucil, or FiberCon. These may help a person produce a bowel movement.
A person should talk with their healthcare professional before taking an herbal remedy because it may interfere with certain medications.
Healthcare professionals generally consider laxatives safe and effective when taken as directed and for short periods. However, like all medications, a person may develop side effects from using laxatives to treat OIC. Some common side effects include:
A person taking a laxative for OIC should talk with their healthcare professional if symptoms do not improve or they experience concerning symptoms related to laxative use.
Healthcare professionals prescribe opioids to treat chronic pain due to various conditions. They also prescribe opioids to treat pain during cancer treatment and during the later stages of cancer.
Healthcare professionals may prescribe opioids to treat chronic pain, including:
According to data collected from 1999–2012, about 22% of United States adults experience chronic pain, with about 7% reporting moderate to severe pain. Further, the results of various studies suggest that opioid-induced constipation affects 41–81% of people with chronic pain that does not result from cancer.
Healthcare professionals often prescribe opioid medications for people living with cancer, especially when the disease progresses to later stages.
In 2017, researchers published the results of an investigation into opioid prescription trends over a 6-year period for people living with cancer. They looked specifically at changes in the type and dose of opioids prescribed.
The researchers studied 750 relevant U.S. health records from 2010–2015. Their findings suggest that pain affects:
In addition to OIC, opioids can have other serious adverse effects. These include:
Both the Department of Health and Human Services and the Centers for Disease Control and Prevention (CDC) have expressed concern about the overprescription of these types of medications.
Opioid pain relief can cause constipation and other digestive problems, as they reduce nervous system activity. OIC is a common complaint among people who take opioids for pain relief.
Drinking plenty of water, eating high-fiber foods, and keeping active, where possible, can help reduce the impact.
If these natural means do not provide relief for OIC, a healthcare professional can recommend additional treatment options, such as laxatives, supplements, or prescription medications.
Last medically reviewed on January 7, 2022
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