Constipation in serious illness and with pain medicines

Constipation is one of the most common and most overlooked problems in serious illness, especially for anyone taking opioid pain medicine. It’s uncomfortable, and left alone it can become serious. The good news is that it’s usually preventable.

Why it happens

Opioid pain medicines cause constipation, and so can eating and moving less.¹ Tell the doctor or nurse as soon as it starts; early treatment helps prevent a blockage.¹

Fluids, activity and a routine

Drinking 8 cups of water or clear liquids a day helps, if allowed; coffee, prune juice and warm drinks can help things move.¹ Try to be active every day, even light exercise in a bed or chair.¹ Eat at the same times each day and keep a record of bowel movements.¹

Ask before adding fiber

Check with the doctor before adding fiber. For some people, especially those eating and drinking little, high-fiber foods and supplements make constipation worse.¹

Medicines the doctor may suggest

Use only the treatments the doctor recommends.¹ Options include stool softeners such as docusate, laxatives that pull water into the bowel such as polyethylene glycol, and laxatives that make the bowel move such as senna.¹ Don’t use suppositories or enemas unless the doctor recommends them.¹ Many people on opioids are started on a laxative at the same time.

What’s normal, and when to call

The goal is a bowel movement every day or every other day without hard stool or straining.¹ Call if there are fewer than three bowel movements in a week, or severe belly pain or vomiting.¹