Far too many medications can slow the digestive tract and contribute to infrequent bowel movements or hard stool that may be painful to pass. How can a person overcome this type of drug-induced constipation?
Prunes for Drug-Induced Constipation:
Q. I am bothered by constipation because I take hydrocodone (Vicodin). To counteract this problem, I eat 5 or 10 prunes a day and take one tablespoon of psyllium husks (at a different time from the prunes).
The only problem with my regimen is that prunes add calories and the psyllium container warns against taking the fiber within an hour or two of other medications.
Constipation Due to Narcotic Medication:
A. Narcotic pain medicines like hydrocodone are notorious for causing constipation. Your regimen is excellent and should help many others as well.
Prescription Medicines to Ease Drug-Induced Constipation:
If natural approaches like yours don’t do the job, there are two prescription drugs to overcome this complication. One is an injection, methylnaltrexone (Relistor). The other, naloxegol (Movantik), is a pill. Side effects of either drug may include abdominal pain and diarrhea.
A few years ago, we heard from another reader about a friend’s problem:
“Recently I took a dear friend to the ER. We thought she had a urinary tract infection. She was so weak she needed a wheelchair to get into the hospital.
“After running numerous tests, they ruled out infection. The problem turned out to be under-treatment of her chronic back pain due to spinal stenosis. She was cutting her pain medicine in half because she worried that it would cause severe constipation.
“The doctor said she needed the full dose of narcotic to avoid unbearable pain. That turned out to be just the right advice. She has not had another episode since she started taking the full dose of pain medication. What can she do about the constipation that will inevitably result?”
We responded by telling her about methylnatrexone, which had just been approved for drug-induced constipation. This injection may be prescribed in cases like those of your friend if usual measures and laxatives like Miralax have not worked. A study that had just been published in The New England Journal of Medicine (June 19, 2014) showed that naloxegol was also helpful in overcoming narcotic-induced constipation.
In less severe cases, some of the home remedies we suggest in our Guide to Constipation may be helpful. Sugarless gum can often ease difficulties, as can “Power Pudding,” which teams the power of prunes in the form of prune juice with that of wheat bran and applesauce.
