Constipation and Narcotics: Get a Move On


If you’re taking a narcotic for your pain, chances are good you’re dealing with an unpleasant side effect: constipation.

As a topic, constipation doesn’t exactly make for good dinner conversation. But knowing what to eat and drink can make a dramatic difference for the more than four million Americans who regularly take opioids for pain relief. All of these drugs can cause constipation, which is defined as having a bowel movement less than three times a week where the stool is hard, dry, small in size, and difficult to eliminate. But narcotic-induced constipation is more than a temporary nuisance; it can be debilitating and even lead to hemorrhoids, diverticulitis (small pouches in the colon), or rectal prolapse, where the walls of the rectum protrude through the anus. In fact, a stopped-up bowel is one of the most frequent reasons pain patients stop taking their opioid meds. While inactivity, irritable bowel syndrome, stress, obesity, sedatives, and antidepressants can all bring on constipation, a poor diet is, by far, the most common cause.

What’s Food Got To Do With It?

The typical American diet is a breeding ground for sluggish bowels: It’s high in stool-binding fat and low in stool-softening fiber and water. Fatty foods such as cheese, ice cream French fries, eggs, and meat are some of the worst offenders. Combine that with a lack of daily exercise, and it’s no wonder constipation is one of the biggest gastrointestinal (GI) complaints in the United States, accounting for 2.5 million doctor visits a year.

As food moves through our large intestine (aka the colon), excess water is absorbed and waste is formed into a stool that is pushed toward the rectum by muscle contractions. Constipation happens when the colon has absorbed too much water or when the muscles that line the colon are sluggish, causing the stool to move too slowly and allowing more time for water to be absorbed, making the stool hard, small, and difficult to pass.

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