please help with eating

[sweetpea94]

Thank-you to everyone here who has helped me through these last 10 days of c/t off stadol and lortab.  Today is my first day back from summer break to teach, and I still have not eaten anything to speak of, and diarrhea is constant.  I have tried BRAT diet but goes straight through me even if I can get it down.  I have taken Immodium after Immodium with no results.  I can't teach like this, and I feel so run down.  Help!!! I am taking B-6.

[Jeffrey T Junig, MD PhD]

Hi Sweetpea,

I'm sorry for the delay, which likely seems twice as long when in the condition you described.  I do not have a great answer-- I would agree with the imodium (immodium), and usually that does the trick.

Trying to think outside the box, there are different kinds of diarrhea;  sometimes caused by the inability to absorb fluids, and other times from increased intestinal motility.  The diarrhea from opiate withdrawal is in the latter category;  that is why it is associated with cramping, pain, and the rumble of noise from your belly.  The movement of the bowel is activated by the parasympathetic nervous system through the release of acetylcholine, so 'anitcholinergic' medications are generally constipating and slow bowel activity.  The classic med is donnatal, for irritable bowel;  other anticholinergic meds would include benadryl (an antihistamine, but with anticholinergic side effects) or scopolamine.  In that light I might try scopolamine- skin patches are sold over the counter and are placed on the skin behind the ear-- place your right over the.... that was going to be a joke, sorry-- they don't have to be on any particular area of skin, even though many people think they go behind the ear to affect motion centers there.. but that spot is chosen only because it is a good area with little hair to get in the way.

I like Eagle's answer too-- with nausea or diarrhea many people make the mistake of going too far too fast.  You want to stick with 'isotonic' liquids like gatorade, not water, in small amounts.  You would be better off taking in a teaspoon every five minutes than a cup every 30 minutes-- just take tiny sips now and then.  I might avoid the peanut butter, just because it has so much oil in it-- but the cheese and yogurt are good, providing you are not lactose intolerant.  Try the motility thing as well-- and don't forget to taper off the imodium (immodium), as it is replacing the opiate effects at the bowel and if you stop it abruptly you will only be back where you began.

[theeagle]

Until SubDoc Jeff gets with you I will relay what the dieticians have me doing..... Its a grazing diet - a transition thing for nutrition while your body catches up from WD's.  Some peanut butter - hunk of cheese - fruit - yogurt - - stuff like that.....Keep what appeals to you close and grab a couple bites every 20-30 minutes or whatever works with your schedule. Chicken noodle soup / most soups / are usually good for later.....Drinks like Ensure or Walgreens store brand are good.  The idea is more a constant intake of a few ounces of something and doing it as often as possible.  Watch the hydration very closely if you arent keeping adequate fluids in yourself. Avoid caffeine and acids - think citrus / tomato -  and pick up some white grape juice.....warm, flat, 7-UP / open and let set out.......   and keep asking if you have further questions....

[Lisa54]

I can relate to you on the diarrhea and loss of appetite.  I'm on my 20th day w/o oxycontin and Lortab and still have bouts of diarrhea.  I've lost 10 lbs since July 21st.

[sweetpea94]

Well, Lisa54,we have been w/o for about the same amount of time and lost the same amount of weight.  Today, I had to run from my classroom--so embarrassing!  Everything runs right through me.  I dare not eat except at night, I guess, from now on.  My stomach makes so much noise, my students (high school) are laughing (I just laugh with them; it is the least of my woes).  Immodium is absolutely NO good.  Fibercon doesn't work--been on it for 2 weeks.  I've tried peppermint capsules and Probiotic.  Help, someone.  I don't even crave the narcotics.  I just crave having no diarrhea.  Constant and chronic diarrhea is the reason I was put on narcotics in the first place when nothine else helped.  I am at wit's end.  Thanks, I've vented.

[theeagle]

Try those small amounts of cheese (in particular) for awhile.......very small pieces but eating it often,  The lortabs (all narcotics) decrease GI motility when on them. But the extreme looseness is part of stopping the lortabs. The cheese and the fiber should be a good combo for strengthening the process. And limit strict fluid intake for a short period.  and good luck with all................

[Lisa54]

I hope that you are doing better.  Mine seems to have let up a little bit.