OIC: A Quality of Life Issue
When I was 54, I was diagnosed with stage 2 breast cancer. To treat my cancer, I underwent three surgeries: a lumpectomy; a surgery to implant a catheter and a small inflatable balloon to be used for five days of targeted radiation therapy; and finally, a total hysterectomy to rid my system of estrogen, because my breast cancer was what my doctor called hormone receptor-positive. Two years later, I had to get a spinal fusion in my back. And recently, I had my gallbladder removed and I am the proud owner of two brand-new titanium knees.
Needless to say, I’m very familiar with surgery and the uncomfortable aftermath—and I’m not just talking about the pain from the incision site. I’m talking about opioid-induced constipation (OIC). After surgeries, it’s not unusual for me to go three and a half days without a bowel movement because of the opioid pain relievers I’m prescribed, like Vicodin or Percocet.
You can imagine how miserable it makes me feel. The pain from surgery is constant and acute; it’s always there. OIC is more of a quality of life issue.
You feel bloated. You need to go but can’t. You’re hungry, but eating anything will just make you feel even more bloated. Even the usual tricks for relieving constipation, like drinking lots of fluids or taking over-the-counter powder laxatives, don’t always work when you’re taking opioids for pain.
But since I’m a seasoned surgery veteran, I’ve learned a few tricks of my own. First and foremost, I try to wean myself off the pain medicines as quickly as I can. After the first few days post-surgery, instead of taking two pills, I’ll take one. By the third or fourth week, I switch completely to over-the-counter non-steroidal anti-inflammatory drugs (NSAIDs) like ibuprofen to handle the pain. Of course, I drink plenty of fluids, especially water, use stool-softening agents, and increase my fiber intake by eating lots of fruits of vegetables. Grapefruit is my go-to, although some folks taking certain meds need to avoid grapefruit.
Most importantly, I prepare myself mentally. Before I have surgery, I know OIC will likely be a problem; but I always have to remember that usually, the benefits of surgery outweigh the short-term discomfort of OIC. I just try to suck it up, because I’m fortunate my OIC is caused by opioids after surgery, and not opioids for a long-term pain problem.
My best advice for others experiencing OIC is to talk to their doctor. If it’s a long-term problem, there are medicines to help. If it’s short term, there are diet and lifestyle changes you can make to counteract the effects.
Jane has had more than six surgeries in her lifetime and as a result, has learned how to deal with the uncomfortable aftermath of opioid-induced constipation.