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Constipation due to Opoid medications (pain medication)

Practice Consideration

Constipation due to Opoid medications (pain medication)
Constipation is defined as difficulty in bowl movements characterized by reduced frequency or dyschezia (painful, ard, or incomplete evacuations).(1)  Normal bowl movements can range from 3 per day to 3 per week.  

The following is a list of contributing factors for constipation, many of which respond to nutrition interventions of increasing fluid and increasing fiber:
  • Chronic use of opiates (common in oncology or chronic pain patients)
  • Low fiber content in diet
  • (DRI recommendation for adults is The Dietary Guidelines for Americans recommends a dietary fiber intake of 14 grams per 1 000 kcal)
  • Low fluid intake
  • DRI recommendation for adults males 50 and under with ~2200 kcal is 3 L per day from beverage/water and for those 51 and over is 3.7L:  women under 50 should consume 2.2 L and those 51 and over 2.7L per day
  • Enteral feeding guidelines from ASPEN recommend  20 to 40 ml/kg/day or 1 to 1.5 ml/kcal of energy expended (See Tool Kit)
  • Low food/calorie intake
  • Lack of exercise or immobility
  • Laxitive abuse
  • Dysmotility disorders
  • Gastrointestinal Disorders (diseases of upper GI tract, irritable bowel syndrome, fissures)
  • Nuerological disorders that affect muscle tone and function
Patient information may also be distributed by physicians. See an example

Read more about constipation and medications used to treat constipation.
Updated January 16, 2019

REFERENCES

U.S. Department of Health and Human Services and U.S. Department of Agriculture. 2015 – 2020 Dietary Guidelines for Americans. 8th Edition. December 2015. Available at https://health.gov/dietaryguidelines/2015/guidelines/.

Chapter 4, Water, Dietary Reference Intakes for  Water, Potassium, Sodium, Chloride and Sulfate.  National Academies Press.     Available at: https://www.nap.edu/read/10925/chapter/6.  Accessed Jan 2, 2018 
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