Causes of Opiate-Induced Constipation (OIC)

 

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Opiates are commonly used for pain management. They originated from the poppy plant, where “milk of the poppy” was used in early times to treat pain. Today, it’s been prescribed by doctors to deal with all manner of pain, from post-surgery recovery to pre-surgery anesthetic. It\s main effect is to stimulate the brain’s reward center, but it has an inconvenient side effect: Constipation.

Definition of Constipation

Put it simply, it’s difficulty passing stool. Constipation is also described as the reduced frequency of passing stool.  It can lead to a variety of problems, but it also has a variety of reasons why it happens.

What are the Causes?

Outside opiate use, constipation can be caused by many things. The most common cause is lack of fiber. Eating plenty of meats and sugars can cause hard stool. The second most common reason is dehydration. The body pulls water from its system to soften stool, so lack of it can cause problems. The other causes can be lack of potassium, excess calcium, problems in the kidney, liver and so on. With this considered, what’s the reason behind Opiate-Induced Constipation?

id=”how_opiates_cause_constipation”How Opiates Cause Constipation

Opiates have a profound ability to slow down nerve functions. This is what makes them excellent muscle relaxants. The digestive system, specifically the area around the gastrointestinal tract, happens to have a nervous network. The nervous network is so expansive that it has a role in influencing behavioral, sexual and immune functions. (It’s practically a brain, so the saying “thinking with your stomach” and “gut feeling” may have some truth to it.)

Since opiates have the ability to slow down nervous activity, it can affect the digestive system’s nervous network. This means your intestines can slow down. Specifically, it can affect the intestine’s undulating movements known as “peristalsis.” The effects that lead to constipation are threefold. First, the slowed movement can cause food not to pass through as efficiently. Second, the diminished nerve reaction means the intestines won’t pull as much fluids. Third, the reaction from the opiates reduces the “urge” to go for a number two.

With all these combined, you have constipation. Though it’s not heavy enough to impact someone’s life completely, it can cause complications if left untreated. Food that’s been in your large intestine for some time can cause infections, stomach aches and gut-wrenching times in the toilet. So, how do treat OIC?

Treatment for OIC

It’s either a combination of medical and lifestyle changes. Medical methods have you taking certain medication, most of which are over-the-counter.

The meds used to treat constipation is as follows:

  • Prostaglandin or other prokinetic drugs – these promote your intestine’s fluid absorption, leading to softer stool
  • Osmotic Laxatives – same with prokinetic drugs, they increase the amount of water in your digestive system
  • Emollients – they lubricate stool, making it easier to pass
  • Stimulant Cathartics – these meds are made to directly counter the constipating effects of opiates.

For lifestyle changes, it can be simple. Increase your fiber intake, drink more water, exercise. It’s about the same advice given to people who have ordinary constipation issues. This is preferred, as it also promotes a healthier lifestyle altogether.

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