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constipation and percoset
Hi. I am wondering if any one has had this problem before. I take 10-15 mg of Percoset daily for lower back pain- degenerative disc disease. i have been on for 2 years, I am noticing that I am very constipated. The doc recommends Miralax and Colace. If that doesn't work, try Magnesium Citrate, which causes lots of diarahea. He doesn't seem concerned about it, but I am. Do Probiotics work and if so, which kind. Thanks.
Thanks. So sorry that you had cancer. I am always concerned about my gi tract due to surgery and the fact that my older sister had colon cancer 12 years ago. She has been cancer free since the chemo treatments. I will look up percoset charts but know people who take a lot more! Also, some days I only take 10, depending on my back.
I've looked at a lot of equivalency charts, and each one is different. I am completely unsure if 15mg of Percoset (oxycodone) is a lot or not, say as related to milder codeine drugs that I take, but I do not think you are taking too much, from my memory of making some conversions before. My brain is fried at the moment, just got over cancer and my back goofs up my concentration, but you can do a search online for those charts, and see if you can come up with something. But better yet, you can ask your doc! He will know and can explain how some people take such and so, and how it stacks up to other drugs, and what is considered too much, and so forth.
Well, you hit it on the head. I do have a big tummy. My doc had me start exercising moderately, to build up core strength but my back started hurting so much more that he had me stop, until after the shots to see if they work. Yes, he did say that I will have to take the Miralax and Colace ( must say I have not been taking the colace like I should since the Miralax seems to work), as long as I am on pain meds. Do you think 15 mg. of percoset is a high dose? I wonder about it and am always concerned about meds I am given.
Oh, yes, the shots, I forgot, that's where steroids got in the picture. I'm glad you had bowel movements. Obviously if they slow again, use the Miralax, since the doc said you won't get a habit with it. I just knew in general depending on laxatives can make it hard to have a real bowel movement whenever your condition changes...but in your case, you just may need it to stay regular, since you may be on pain-killers for quite a while.
You were talking about what may have caused your back problem, and your list does sound like those things hurt your back. Also, another thing is IF you have a tummy that is too big, it will pull on the back, so you can do stomach muscle-strenghtening exercises and lose a few pounds, and it will help your pain a lot. As for my problems being "much worse" than yours, hon, it's all relative. People can get used to all sorts of things. And we really have no choice but to go forward. But thank you for sympathizing.
You were talking about what may have caused your back problem, and your list does sound like those things hurt your back. Also, another thing is IF you have a tummy that is too big, it will pull on the back, so you can do stomach muscle-strenghtening exercises and lose a few pounds, and it will help your pain a lot. As for my problems being "much worse" than yours, hon, it's all relative. People can get used to all sorts of things. And we really have no choice but to go forward. But thank you for sympathizing.
Thanks for the great feedback. Yes, I do not want to go off the meds as physical therapy hasn't helped and the doc said that the next step may be spinal fusion. Believe me, I do not want anyone cutting on my back. I am not even happy with having the epidural shots in my back ( I think that's where the confusion about predisone came up). I think that is what they inject into your spine. The last two days I have had bowel movements and today decided not to take the Miralax everyday, even though the doc said it's not addicting. It sounds like your problems are much worse than mine. Doc said mine is probably caused by the aging process. I also think that there are other factors. I was a waitress for 20 years, until I went to college and got my degree. Lots of carrying heavy things, but lots of slips and falls. Plus, I have been in a few car accidents when I was younger.
SUE (and the well-intended and good person CAREGIVER), just as a followup comment to respond to the latest posts, and knowing full well I may be wrong, I have been taking pain killers, namely codeine and pregabalin, for many years, and so I have experienced constipation. But I really got it bad when I had cancer and was given hydrocodone to kill the pain I had from chemo treatments and following surgery. In both situations, while increasing fiber WITHOUT bowel movements will clog up any living thing, nevertheless as long as your bowels are made to move, and as long as you drink water and exercise, and as you slowly, which I said before, slowly introduce more fibers in your diet, you're not going to explode. For while opiates and gaba drugs may slow movement, so too will not enough fiber in the waste, i.e. there's nothing to move. As long as fiber is combined with plenty of extra water, with five or six glasses daily being fine, the bowels WILL move under normal constipation circumstances, and under medicine-induced constipation, as long as some way of making the bowels move is used, then fiber is not the enemy.
Actually, pain-killers don't ONLY slow bowel movement, but primarily they are drying in their effect, hence the sensation of "dry mouth." This is why water is so important. But if you only drink lots of water and only eat easy-to-digest foods like applesauce and mashed potatoes, you'll wind up squirting out diarrhea, because many people who take pain-killers get diarrhea and not constipation as a side effect, and diet is why. However, since constipation is waste stuck in the bowel, and since introducing bulk via fiber in that stuck intestine, and eating it without copious water, yes, you will get to feeling REALLY full, and this is why they introdued enemas and laxatives of varying kinds, to artificially get the bowels to move. But it is not realistic to only use laxatives to prevent constipation, when fiber, water, and exercise are also necessary to keep NORMAL people regular. In other words, don't throw the baby out with the bathwater.
I might add that if the proposed solution to constipation is to stop pain-killers, then one MUST address the constipation correctly, for pain can make life not worth living. I live with pain for nearly my entire life, no meds for 30 years, then meds almost 10 years, because pain became especially bad as I am older, and while I am not in a rest home, my back is fractured from a car accident, I have chemo-induced peripheral neuropathy, my thoracic, lumbar, and lumbosacral spines are a wreck. However, I do not have sciatica from my low back pain, rather my pain is from facet joint syndrome, where bone rubs against bone due to loss of cartilage that is normally in the spinal processes that go around the spinal cord from the vertebra, to in part allow movement in all directions. And my various other pains are from other sorts of abnormalities, too many to list.
I have many other symptoms from my back, but sciatica is not one of them, and yet I am disabled by my condition, the pain is not exquisite but it is so serious that even with pain control, I cannot do so many things I used to do. I'll say it again, my life would not be worth living without my medicines. The problem with people in rest homes who receive pain medicines, is they do not get enough water, they are not gotten up out of bed enough, they do not eat the correct foods, and not only do their bowels quit working, all their organs shut down, and it is a combination effect of poor care and lack of correction of medical problems like constipation that leads to death, else we'd have exploded colons on a lot of death certificates out of nursing homes.
I'm sorry to be so disagreeable with other post ideas here, and advice given by others is not entirely incorrect, and I can also be incorrect, but it is important to treat this issue with some realistic expectations as to not TAKING AWAY pain medicines, because to me and many others, this is cruel treatment for our elders. They need their medicines. And I think the one thing that is truly unusual to me is to ever give a medicine that reverses opiate effect in order to end constipation. I was on a morphine drip in the hospital, my bowels became empacted, and the nurses cleared it up, but NO WAY could the pain medicines be stopped with the exquistely painful and deforming compression fractures of three vertebra in my thoracic spine.
And one final item, I am unsure why the topic of prednisone came up. I think, SUE, you did ask about probiotics. Perhaps there is some confusion there. But some statements were made in that post that opiates won't help lower back pain, and I can testify, as I have taken codeine and pregabalin not together, but with one and after a while with the other, and BOTH reduce back pain. Anything that tells the nerves not to scream in pain works. Natural approaches to pain are all fine and good, but in the end, unless the pain is mild and physical therapy and biofeedback and other approaches have helped, there ARE plenty of cases where pain medicine has a place in the treatment of people who would otherwise suffer entirely too much as a matter of ethics.
Again, all, excuse my extraneous information here, but I just felt the other side needed to be presented in-depth, so that people can now choose what is best, rather than perhaps not getting enough information on this pain issue. I have beaten constipation for almost ten years now, I rarely use laxatives (and do so with success when all else fails), but my diet, hydration, and physical fitness have kept me regular as clockwork, so I just felt I couldn't let my original advice be thrown out the window as if it were not true. And I think partly I get a little bent out of shape when anyone ever suggests taking away pain medicines as part of a normal treatment program. GG
Actually, pain-killers don't ONLY slow bowel movement, but primarily they are drying in their effect, hence the sensation of "dry mouth." This is why water is so important. But if you only drink lots of water and only eat easy-to-digest foods like applesauce and mashed potatoes, you'll wind up squirting out diarrhea, because many people who take pain-killers get diarrhea and not constipation as a side effect, and diet is why. However, since constipation is waste stuck in the bowel, and since introducing bulk via fiber in that stuck intestine, and eating it without copious water, yes, you will get to feeling REALLY full, and this is why they introdued enemas and laxatives of varying kinds, to artificially get the bowels to move. But it is not realistic to only use laxatives to prevent constipation, when fiber, water, and exercise are also necessary to keep NORMAL people regular. In other words, don't throw the baby out with the bathwater.
I might add that if the proposed solution to constipation is to stop pain-killers, then one MUST address the constipation correctly, for pain can make life not worth living. I live with pain for nearly my entire life, no meds for 30 years, then meds almost 10 years, because pain became especially bad as I am older, and while I am not in a rest home, my back is fractured from a car accident, I have chemo-induced peripheral neuropathy, my thoracic, lumbar, and lumbosacral spines are a wreck. However, I do not have sciatica from my low back pain, rather my pain is from facet joint syndrome, where bone rubs against bone due to loss of cartilage that is normally in the spinal processes that go around the spinal cord from the vertebra, to in part allow movement in all directions. And my various other pains are from other sorts of abnormalities, too many to list.
I have many other symptoms from my back, but sciatica is not one of them, and yet I am disabled by my condition, the pain is not exquisite but it is so serious that even with pain control, I cannot do so many things I used to do. I'll say it again, my life would not be worth living without my medicines. The problem with people in rest homes who receive pain medicines, is they do not get enough water, they are not gotten up out of bed enough, they do not eat the correct foods, and not only do their bowels quit working, all their organs shut down, and it is a combination effect of poor care and lack of correction of medical problems like constipation that leads to death, else we'd have exploded colons on a lot of death certificates out of nursing homes.
I'm sorry to be so disagreeable with other post ideas here, and advice given by others is not entirely incorrect, and I can also be incorrect, but it is important to treat this issue with some realistic expectations as to not TAKING AWAY pain medicines, because to me and many others, this is cruel treatment for our elders. They need their medicines. And I think the one thing that is truly unusual to me is to ever give a medicine that reverses opiate effect in order to end constipation. I was on a morphine drip in the hospital, my bowels became empacted, and the nurses cleared it up, but NO WAY could the pain medicines be stopped with the exquistely painful and deforming compression fractures of three vertebra in my thoracic spine.
And one final item, I am unsure why the topic of prednisone came up. I think, SUE, you did ask about probiotics. Perhaps there is some confusion there. But some statements were made in that post that opiates won't help lower back pain, and I can testify, as I have taken codeine and pregabalin not together, but with one and after a while with the other, and BOTH reduce back pain. Anything that tells the nerves not to scream in pain works. Natural approaches to pain are all fine and good, but in the end, unless the pain is mild and physical therapy and biofeedback and other approaches have helped, there ARE plenty of cases where pain medicine has a place in the treatment of people who would otherwise suffer entirely too much as a matter of ethics.
Again, all, excuse my extraneous information here, but I just felt the other side needed to be presented in-depth, so that people can now choose what is best, rather than perhaps not getting enough information on this pain issue. I have beaten constipation for almost ten years now, I rarely use laxatives (and do so with success when all else fails), but my diet, hydration, and physical fitness have kept me regular as clockwork, so I just felt I couldn't let my original advice be thrown out the window as if it were not true. And I think partly I get a little bent out of shape when anyone ever suggests taking away pain medicines as part of a normal treatment program. GG
Thanks for the feedback. The other day I completed the 2nd set of epidural shots. They don't seem to work well. I am going, in July, for the 3rd one. I wonder why my doc has me on percoset then? Yesterday and today I actually had bowel movements. I have only had to use the mag. citrate 2 times in the last couple of months, which I think is a good thing. I am going to buy some Activia today and see how that works. He also has prescribed Bentyl, for colon spasms, but I don't like to take it as I have heard it can slow things down. Forgot to mention that I had a colon resection in 2008, 7 inches of colon removed due to multiples episodes of diverticulitis that would not respond to antibiotics.
Percocet is inappropriate for back pain, though commonly prescribed. The pain comes from glial cell stimulation, generally secondary to compression of the sciatic nerve. A laminectomy should be considered. Good hydration will sometimes lesson the pressure. These cells do not react to opiates. An electrical TENS device is far more effective, as well as ordinary non-steroidal anti-inflammatorys (NSAIDS). The use of prednisone is contraindicated these days for a number of excellent reasons. Most physicians in the United States will not prescribe a steroid for back pain. That being said, sometimes the pain can become unbearable and actually prevent one from standing up. For the VERY short term (a day or so), prednisone can provide relief. The problem is the patient feels so much relief he/she will demand additional prednisone, which, over the long term may cause severe life-threatening complications.
All opiates (Percocet containes an opiate) inhibit peristalsis, which is the muscular sequence of contractions that moves (squeezes) fecal matter through the intestines, to the lower bowel, and to the anus. Fibre is contraindicated. Do NOT increase use of fibre if you have constipation secondary to opiate use. Use of fibre may result in a life-threatening blockage that can only be resolved by surgical intervention, bowel resection, and a colostomy (usually temporary). Continued use of an opiate invariably causes further constipation and in many cases complete bowel blockage. This is a major cause of death in the elderly in nursing homes. They are prescribed opiates, the bowel becomes obstructed, they are provided with "fibre" and they stop eating and drinking. The answer is to end the use of the opiate in in many cases the intestine will return to normal within three to five days. More water and laxatives do not help. The specific drug to take to immediately end the problem is a prescription opiate antagonist, namely naltrexane.
The probiotics can help break down waste with the "good" bacteria in them, any kind is fine, I know of Activia yogurt and Acidophilus milk in the stores, but you can check labels of other kinds.
The pain-killers are of course what are constipating you. To offset it, in addition to what the doc said, and hopefully not cause quite as much diarrhea, is to (a) drink extra water, shoot for five or six glasses, (b) slowly increase fiber foods in your diet, like oat cereal, whole wheat bread, vegies, and fruit as a snack, (c) get enough exercise, at least three or four times a week, to where you break a sweat. Those are the standard three things you can do to help constipation along a little better.
But sometimes, despite these steps, those meds will still tend to goof up the digestion, so your doc suggested some fiber and laxative type things, and so you might have luck with another rather natural type of lax pill called "Senocot," you take one pill, then the next day take another, and you'll have you a bowel movement the following day. Do not take them routinely, just kind of rotate whatever all you're doing, or you can become dependent on laxatives in general.
Then there is also an emergency ointment you squirt in there, they come in a little box at the pharmacy "BabyLax" or "PediaLax," use two, one right after the other, and within minutes, it should come out, and if not, repeat once. But ONLY do this when you know the waste is right there but it simply will not move. Don't use it regularly or too many times in one go.
The pain-killers are of course what are constipating you. To offset it, in addition to what the doc said, and hopefully not cause quite as much diarrhea, is to (a) drink extra water, shoot for five or six glasses, (b) slowly increase fiber foods in your diet, like oat cereal, whole wheat bread, vegies, and fruit as a snack, (c) get enough exercise, at least three or four times a week, to where you break a sweat. Those are the standard three things you can do to help constipation along a little better.
But sometimes, despite these steps, those meds will still tend to goof up the digestion, so your doc suggested some fiber and laxative type things, and so you might have luck with another rather natural type of lax pill called "Senocot," you take one pill, then the next day take another, and you'll have you a bowel movement the following day. Do not take them routinely, just kind of rotate whatever all you're doing, or you can become dependent on laxatives in general.
Then there is also an emergency ointment you squirt in there, they come in a little box at the pharmacy "BabyLax" or "PediaLax," use two, one right after the other, and within minutes, it should come out, and if not, repeat once. But ONLY do this when you know the waste is right there but it simply will not move. Don't use it regularly or too many times in one go.
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