9 Ways to Beat Painkiller-Induced Constipation

Doctor William C Lloyd Healthgrades Medical Reviewer
Medically Reviewed By William C. Lloyd III, MD, FACS
Written By Jennifer Larson on March 8, 2022
  • row-of-prescription-pill-bottles
    Constipation is a common side effect of opioid painkillers.
    An effective pain killer can feel like a gift from heaven when you’re really hurting. They can reduce pain from surgery, injuries and illnesses, but the pain relief can come at a price, especially if you’re taking an opioid painkiller. Opioid analgesics are a step up from pain-relieving drugs like ibuprofen, naproxen and acetaminophen. They’re made from a derivative of the opium plant, which was used for centuries to knock out pain. They work well, but they can also make things get a little—or a lot—backed up. One of the most common side effects is constipation. Fortunately, there are some steps you can take to alleviate at least some of that discomfort.  
  • toilet paper in bathroom
    1. Start with a stool softener.
    A stool softener like docusate (Colace) does exactly what the name implies: it makes your stool softer and easier to pass through your digestive tract and out of your body. It works by helping the stool absorb more water. You don’t have to wait until constipation kicks in to start taking the softener, either, since the preventive approach may be even more effective.
  • man in drug store
    2. Add in a laxative.
    Some experts believe that stool softeners by themselves aren’t very effective, so they suggest taking the softener along with an oral laxative. For example, you might try senna, a laxative that irritates the lining of your intestines to get them moving, or sorbitol. Or you could opt for a stimulant laxative like Dulcolax to get your bowels moving. One caution: some types of laxatives can interfere with your body’s ability to absorb some nutrients or interact with other meds you may be taking, so check with your doctor about the best kind for you to try. And keep in mind that bulk laxatives require plenty of hydration to work; without enough water, they may even cause a blockage, so talk to your doctor before choosing your laxative .
  • Consider a Low-Fiber Diet
    3. Eat more fiber.
    You probably hear this a lot, but it bears repeating. Healthcare providers routinely suggest boosting your intake of dietary fiber to ward off constipation. It probably won’t do the trick all by itself if you’re taking a painkiller, but it can certainly help. Whole grains, fresh vegetables and fresh fruits should make regular appearances on your plate.
  • Senior woman drinking water
    4. Drink more water.
    Like the recommendation to eat more fiber, drinking more water is one of those “can’t hurt/might help” recommendations. You might also give prune juice a try. 
  • smiling-woman-in-swimming-pool
    5. Get moving.
    Another lifestyle recommendation that might help your constipation is getting more exercise, which can enhance the efficiency of your digestive system—that is, keep things moving along. While it’s not a surefire guarantee, it’s still a good idea to get regular exercise to benefit your overall health. But consult your doctor about the most appropriate types of physical activity for you, given that you may be limited due to your need for pain medication.
  • Toilet paper
    6. Take time to toilet.
    There are times in life when you need to rush. This is not one of them. Experts suggest developing a regular toilet routine in which you take the time at least twice a day to sit on the toilet. You might have to sit there awhile, as it could take a half hour or longer to have a bowel movement. Just try to be patient. If you find that a particular time works better for you, go with it.
  • suppositories-on-table
    7. Try a suppository.
    If the other methods aren’t working and your doctor feels like it’s time to try something else, a suppository might be the next step. Some people also experience some relief from an enema.
  • Prescription Drugs
    8. Ask for a prescription.
    Recent studies have shown that drugs like naloxegol (Movantik) and methylnaltrexone (Relistor) can work to protect the GI tract from the effects of opioids, thus relieving opioid-induced constipation and getting you regular again.
  • Doctor filling out prescription
    9. Ask about other pain medications.
    If you’re really having trouble with constipation and other side effects from the painkiller you’re taking, you might consider switching to a different type of pain relief medication. For example, there is a patch that delivers a pain reliever through your skin that might be an option, since it tends to be less likely to cause constipation. Prolonged-release formulas of certain painkillers could also be potential options, since they may be less likely to contribute to constipation.
9 Ways to Beat Painkiller-Induced Constipation
  1. Kumar L, et al. Opioid-Induced Constipation: Pathophysiology, Clinical Consequences, and Management. Gastroenterology Research and Practice. 2014; Article ID 141737, 6 pages http://dx.doi.org/10.1155/2014/141737
  2. Over-the-counter laxatives for constipation: Use with caution. Mayo Clinic. http://www.mayoclinic.org/diseases-conditions/constipation/in-depth/laxatives/art-20045906
  3. Pain relief, opioids, and constipation. Harvard Health Publications. Harvard Medical School. http://www.health.harvard.edu/pain/pain-relief-opioids-and-constipation
  4. Portenoy RK, et al. Subcutaneous Methylnaltrexone for the Treatment of Opioid-Induced Constipation in Patients with Advanced Illness: A Double-Blind, Randomized, Parallel Group, Dose-Ranging Study. Journal of Pain and Symptom Management. May 2008; Volume 35, Issue 5, Pages 458–468. http://www.jpsmjournal.com/article/S0885-3924(08)00093-6/abstract
  5. Swegle JM and Logemann C. Management of Common Opioid-Induced Adverse Effects. American Family Physician. 2006 Oct 15;74(8):1347-1354. http://www.aafp.org/afp/2006/1015/p1347.html#
  6. Thomas J, et al. Methylnaltrexone for Opioid-Induced Constipation in Advanced Illness. New England Journal of Medicine. 2008;358:2332-43. http://www.nejm.org/doi/pdf/10.1056/NEJMoa0707377

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Last Review Date: 2022 Mar 8
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