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Constipation from Opioids (Narcotics) (4843)

Constipation from Opioids (Narcotics) (4843) - Clinical Hub, Patient Education, Health and Nutrition Facts For You, GI


Constipation from Opioids (Narcotics)

Narcotic pain medicine causes constipation
in most people. This medicine slows down
bowel movements moving through the
intestine. This causes the stool to become
hard. If you have hard bowel movements,
have trouble passing bowel movements, and
the movements are not often enough, then
you have constipation.

This can be a problem. It may last as long as
you are taking narcotic medicine. So, it is
important to learn how to prevent and treat

What can I do to prevent constipation?

Once you go home, you will need a plan to
avoid this problem. Stick to it as long as
you are taking narcotic pain medicine.
Review your plan with your doctor or nurse.
Here are some things to include in your

 Eat foods that have helped you to
relieve constipation in the past.

 Eat foods high in fiber or roughage.
This includes foods such as
uncooked fruits, raw vegetables, and
whole grain breads and cereals. Try
prune juice. Buy some unprocessed
bran and add 1 or 2 tablespoons to
your food. Keep a shaker of bran
handy at mealtimes and sprinkle it on
foods. If you are not hungry, do not
force yourself to eat fiber.

 Drink plenty of liquids. Eight to ten
8-ounce glasses of fluid each day
will help keep your stools soft.
Warm liquids often help your bowels
to move. Have a warm drink about
half an hour before your planned
time for a bowel movement.

 Exercise as much as you are able
each day or at least every other day.
Increase the amount you walk.
Check with your doctor or nurse
about the exercises that are best for

 Plan your bowel movements for the
same time each day, if you can. Set
aside time for sitting on the toilet or
commode. The best time is after a

What about stool softeners and laxatives?

Many people taking narcotic pain medicine
need the help of a stool softener. This alone
may not work. You may need to add a
gentle laxative. Be sure to check with your
doctor or nurse before taking any of these on
your own.

Your doctor or nurse may suggest taking a
laxative on a regular schedule rather than
waiting for constipation to happen. There
are many types and brands of laxatives, and
most need no prescription. Talk to your

doctor about which may work best for you,
and at the best price.

What about bulk laxatives and fiber, like
Metamucil ?

Bulk laxatives and fiber like Metamucil
absorb water and expand to increase bulk
and moisture in the stool. They are not the
best to use for constipation from narcotics.
They should only be used if you are able to
drink plenty of fluids throughout the day.

What about suppositories and enemas?

Both can be used as an added step to treat
constipation. It is not a good idea to rely on
enemas as part of a regular plan to avoid
constipation. Talk to your doctor or nurse
before using either of these options.

What are the important points in my

ξ Put together a plan to prevent
constipation and stick to it as long as
you are taking your narcotic pain

ξ Do not stop taking your pain
medicine even if it is harder to
control the constipation than it is to
control the pain.

ξ Aim for a bowel movement every
second or third day rather than every

ξ Call your doctor before taking any
stool softeners or laxatives.

What are examples of high fiber foods?

Cereals and flours Bran cereals, whole-wheat bread, rye bread and crackers, wheat
germ, corn, cornmeal, wild rice, brown rice, barley, popcorn

Fruits Fresh, canned, or dried fruits, especially those with skin or seeds
(apples, plums, pears, peaches, tomatoes, berries, raisins, and dates)

Vegetables Any raw or cooked vegetable (not overcooked) such as carrots,
cabbage, peas, dry beans, and lentils

High Fiber Home Recipes

Fruit Pudding

1-2 tablespoons one to three times a

Pudding recipe: (in blender combine)
3 oranges peeled
4 apples with skins
2 cups raisins and dates
2 cups prunes
add prune juice to consistency of
sauce or pudding

Can keep in refrigerator 7-10 days, can
be frozen

Bran Muffins

1-2 muffins daily

Bran muffin recipe:
2 ½ teaspoons. baking soda
½ quart buttermilk
2 ½ cups flour (1 ½ whole
wheat; 1 white)*
1 cup sugar
½ package (15 oz.) Raisin Bran
1 teaspoon. salt
2 eggs slightly beaten or 1 cup
egg substitute
½ cup oil
* ½ cup wheat germ may be
substituted for ½ cup whole-wheat

Combine all ingredients. Bake in
greased muffin pans at 400 degrees
for 18-20 minutes. Makes two dozen

American Pain Society (2004). Clinical Practice Guideline: Management of Cancer Pain in Adults and Children.
Glenview, Il.

Spanish version is Health Facts for You #6043.

Your health care team may have given you this information as part of your care. If so, please use it and call if you
have any questions. If this information was not given to you as part of your care, please check with your doctor. This
is not medical advice. This is not to be used for diagnosis or treatment of any medical condition. Because each
person’s health needs are different, you should talk with your doctor or others on your health care team when using
this information. If you have an emergency, please call 911. Copyright © 10/2016 University of Wisconsin Hospitals
and Clinics Authority. All rights reserved. Produced by the Department of Nursing HF#4843.