Eat to Beat Opioid-Induced Constipation
If you’re taking prescription medications to help with pain (also referred to as opioids), you’re likely familiar with an unwelcome side effect: constipation. Many medicines are known to cause constipation, especially narcotics like opioids, so health care providers often recommend some self-care steps, even before constipation has developed, to keep things moving.
The Constipation Myth
“Normal” bowel movement frequency varies widely, and despite what you may have heard, you don’t have to go every day. Some do, and some may have a bowel movement only three times a week. (Another common myth is that wastes stored in the body are absorbed and are dangerous to your health, causing disease or shortening life span). But when you find that you are having far fewer trips to the bathroom than your typical “normal,” you don’t have to stop taking your pain medicine and suffer needlessly.
For most, a few changes in lifestyle are enough to help get things back on track. In addition to increasing your exercise and activity level each week, you can make some dietary changes that will help lessen the chance of constipation.
What to Eat (and Drink)
A well-balanced diet with plenty of fiber
The National Academy of Sciences' Institute of Medicine recommends 38 grams of fiber for men and 25 grams for women 50 and younger; for men and women older than 50, they recommend 30 grams for men and 21 grams for women. If you are taking opioids, it’s even more important to make sure you are getting enough dietary fiber for a healthy digestive system. But if you are immobile, or nearly immobile, consult your doctor before increasing your fiber intake.
Good sources of fiber are fruits, vegetables, legumes (peas, nuts and beans) and whole-grain breads and cereals. The skin of fruits has the most fiber, as do fruits with seeds you can eat, such as strawberries. Bran is another great source, which you can eat in cereal or add to foods like soup or yogurt.
These include prunes and prune juice, apple cider (not apple juice), bran cereals, watermelon, grapes, apricots, rhubarb, carrots, spinach, broccoli, asparagus, lettuce, raisins and whole grains. Sometimes adding legumes and healthy oils, such as olive oil, flaxseed oil or grapeseed oil can also help with constipation.
Plenty of water and other non-caffeinated fluids.
These keep the stool soft and hydrated as it moves through the intestines (Note: milk can cause constipation for some). You can also try warm liquids, especially in the morning, to help get things going.
What to Avoid
Fatty, processed meats and fast foods. Things like bacon, burgers and potato chips are harder to digest and can not only make constipation worse, but also may add to the nausea that often comes with opioid use.
Large meals. Eating several smaller meals throughout the day (rather than a few large ones) makes it easier for the body to digest and can also help prevent nausea.
Foods that cause gas. Sometimes adding fiber to your diet can increase your discomfort, so take it slowly by trial and error, adding one fiber-rich food at a time. If you find you are having gas, bloating or a distended abdomen, reduce your fiber intake and gassy foods, such as beans, cabbage, legumes, apples, grapes and raisins. (Presoak beans to reduce the gas-producing potential, and then discard the soaking water and cook in fresh water.)
Above all, be patient, and talk to your doctor or a registered dietitian if you aren’t getting the relief you need. You may not see results right away, but with continued effort and attention to your diet, you can find your way back to a healthy — and comfortable — digestive system.