Coping with Constipation Caused by Opioid Medication

Patients experiencing chronic pain caused by arthritis often take one or more medications for pain relief.

Unfortunately, constipation is a common side effect of many pain-relief medications (analgesics)—especially opioid pain medications (opioids). Commonly prescribed opioid pain medications can cause constipation because they slow down bowel motility.

While prescription pain medications, or analgesics, are commonly referred to as “painkillers” or “narcotics,” the preferred medical term is opioid pain medications, or opioids, which are the terms used in this article.

Common opioids used for treatment of arthritis pain include:

• Codeine (Tylenol #3)
• Hydrocodone (Vicodin)
• Oxycodone (Percocet, Oxycontin)
• Morphine (MS Contin, Kadian)
• Oxymorphone (Opana)
• Hydromophone (Dilaudid, Exalgo)

These medications may be prescribed for acute flare-ups of pain or for treatment of chronic arthritis pain. Either can lead to constipation, but long term use of opioid pain medications increases the likelihood of developing constipation.

See How to Understand Chronic Pain vs. Acute Pain

Chronic pain is also closely linked to depression, so some patients may be taking an antidepressant medication in addition to an opioid pain reliever. Some antidepressants, such as amitriptyline (Elavil, Endep), sertraline (Zoloft), and imipramine (Tofranil), can also cause constipation. Obviously, patients taking both opioids and antidepressants are at an increased risk for developing constipation.

However, there are effective remedies to address constipation caused by pain medication, including a wide range of self-care techniques. Fortunately, many of the self-care techniques to reduce constipation are helpful in alleviating arthritis symptoms, and are generally healthy lifestyle choices.

For severe constipation, there are also a number of medications and other medical treatments available.