Constipation is an anticipated side effect of opioid use (opioids are a type of pain medication). When left untreated constipation may cause further pain and complications, such as stool impaction, anal fissures or hemorrhoids. Adequate bowel elimination is of particular concern for older adults as many natural body changes, as well as chronic diseases, already impact the ability of older adults to appropriately evacuate their bowels. Opioid use further complicates bowel management by slowing gastric motility. This known side effect requires preventative attention at the start of opioid therapy. Following is information on assessment and management of constipation related to opioid use.
Important medical history -- Prior to prescribing opioid treatment it is important to know:
Usual frequency of bowel movements
Routine size, color, and consistency of bowel movements
A normal bowel movement should be easy to pass, dark brown, mostly even shaped and toothpaste-like in consistency
Review all medications, as others can also cause constipation, including:
Tricyclic antidepressants, antacids, diuretics, iron