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CONSTIPATION

Patients with chronic pain often have constipation as a side effect of their disease and medications. Constipation may produce nausea, vomiting and abdominal cramping pain. The strategy for managing constipation from chronic opioids is to follow a regimen on a routine basis to counteract the constipating effect of the Opioid medication. For many patients, a diet high in fiber (certain fruits, vegetables and cereals) is sufficient. Many patients find that laxatives are necessary, however. The following laxatives have been found to be effective:

  • Senekot
  • Pericolace
  • Milk of Magnesia
  • Maalox
  • Dulcolax tablets or suppositories

The laxatives should be taken in whatever a dose is necessary to provide regular BMs. DO NOT WAIT FOR A CRISIS. If your bowels have not moved for a number of days, you may try a higher dose than usual of your customary laxative or Magnesium Citrate. If constipation is associated with severe nausea or vomiting, use an enema (commercial Fleet’s enema) and/or suppository to relieve the obstruction from below. If these measures are ineffective, seek medical attention. Guidelines for Managing Constipation

  • Increase fluids to at least eight glasses per day.
  • Eat a diet high in fiber.
  • Avoid foods with white sugar, pasta, pastries, cheese and rice.
  • Exercise regularly.
  • Establish regular times for evacuations (usually after a meal).
  • Drink a warm liquid one-half hour before breakfast to stimulate bowel movement.
  • Sit in a modified squatting position for evacuations by placing feet on a stool.
  • Avoid laxative and enema abuse.
Fiber
  • Cellulose
  • Gums
  • Vegetables
  • Legumes (dried peas/beans)
  • Whole-grain products
  • Oat bran
  • Hemicellulose
  • Pectin
  • Bran cereal
  • Apples
  • Whole-grain products
  • Citrus
Tips on Increasing Fiber in Your Diet
  • Increase fiber slowly to give the digestive tract time to adjust and to avoid flatulence and cramping.
  • Increase fluids along with fiber to prevent constipation.
  • Obtain fiber from a variety of sources.
  • Eat whole-grain food because processing tends to decrease fiber content.
  • Choose fruits and vegetables with edible skins and seeds.
  • Eat whole-grains such as barley, bran, brown rice, buckwheat groats, cornmeal, popcorn whole wheat and wheat germ.
  • Store whole grains carefully; they are more perishable than refined grains.
  • Consult your physician regarding the amount of fiber needed in your daily diet.
  • Avoid medication after bran cereal because bran can block medicine absorption.
  • Do not take fiber supplements unless prescribed by a physician.
Fiber Content per Ounce of Food
  • Fruit: 2 grams
  • Whole-grain products: 2 grams
  • Vegetables: 2 grams
  • Cereal: 3 grams
  • Starchy Vegetable: 3 grams
  • Bran Cereal: 8 grams
  • Legumes: 8 grams
  • Nuts and Seeds: 3 gram

Contact Us

13710 Olive Boulevard (Primary Office)
Chesterfield, MO 63017
Telephone: 314-469-PAIN (7246)

Fax: 314-469-7251
Exchange: 314-441-6965 (for after-hour Emergencies Only)

Hours:
Monday thru Friday
8:30 AM – 4:30 PM